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Home My WebLink About08-20-09 (2)COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280801 HARRISBURG, PA 1 ] 128-0801 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT JONES JOHN G 4450 PANZA DRIVE MECHANICSBURG, PA 17050 ,oH ESTATE INFORMATION: ssN: 191-2a-6178 FILE NUMBER: 2109-0782 DECEDENT NAME: JONES BONNIE M DATE OF PAYMENT: 08/20/2009 POSTMARK DATE: 08/19/2009 couNTY: CUMBERLAND DATE OF DEATH: 04/04/2009 REV-1182 EX111-981 NO. CD 011649 ACN ASSESSMENT AMOUNT CONTROL NUMBER 09152168 ~ 555.96 TOTAL AMOUNT PAID: REMARKS: CHECK#1547 SEAL INITIALS: CJ 555.96 RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU BF INDIVIDUAL TAXES Po BDx zeacal HARR158URG PA 77128-0681 uvasas a ,rv :oe-ae: PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE . - ~ „ AND FILE NO -"~FTdXPAYER RESPONSE ACN rr, / <- :iCt1 v~ DATE 21-oR-U78a. 09152168 08-12-2009 aUG 20 ~~ CLEF 0, wl ORPHA^!,° ,,. ~UMEE'~'_' ._ JACpUELIN HOLLAR 136 WOODS DRIVE MECHANICSBURG PA 17050 EST. OF BONNIE M JONES SSN 191-24-6178 DATE OF DEATH 04-04-2009 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 TYPE OF ACCOUNT ® SAVINGS CHECKI N6 TRUST CERTIF. MEMBERS 1ST FCU provitled the Dapa rtment with the inforaatian bales. which has boon used in ealculatinp the potential kex due. Records intlicate that at the death of the above-naa ad docetlant, you we ro a joint owner/bonef iciarv of this aeeoun t. If vpu foal the inf oraation is incorroei, please obtain written correction frog the financial institution, attach a eopv to this fare and return it to the above address. This account is taxable in aeca rtlaneo with the Inheritance Tax laws of the Commonwealth of Penn sYlvania. Please call (717) 787-8827 with Questions. COMPLETE PART 1 BELOW ^ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 230293-00 Account Belanee Percent TaxaDla Amount Subject to Tax Tax Rata Potential Tax Dua PART Data 05-20-2003 Estab llshed $ 7,461.26 X 16.667 S 1,243.57 Te ensure proper credit to the account, two copies of this naf ice oust accomparry payment to the Register of Nill s. Mak1 check payable ie "Re pister of Wills. Apani". NOTE: If tax payments are matlo within three months of 4he de odent's tlaL of tleath, deduct a 5 pveent tliseeunt an tM tax due. Aro Inheritance Tex due will become delinauen4 nine menthe after the data of tleath. A. ~ The above information and tax due is correct. Remit payment to ih• Register of Wills with two copies of this notice to obtain r CHECK a discount or avoid interest, or chock box "A" and return this notiea to the Register of 1 ONE ~ Wills and an official assessment will bo issued by the PA Daoartment of Ravanua. L BLOCK B. ~ Tha above sasak has bean or will ba reported and 4ax paid with the Pennsylvania Inheritance Tra return ONLY to be filed by the estate repro sentat ive. C. ~ The above inf or~ajion is in co rrpet antl/ar tlebks end deductions ware paid. Compl eta PART u2 and/or PART 5 bal ow. PART If intlleatinp a different tax rate, elm ms• state ralatlonshlp to decadent: TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Date Esta611shad 1 2. Account Balance 2 3. Pare ant Taxable 3 X 4. Amount Subject to Tax 4 ~ 5. Debts and Deductions 5 6. Amount Taxable 6 S 7. lax Rate 7 X e. Tax Due e $ PART ucn,.~ nnu DATE PAID PAYEE DESCRIPTION AMOUNT PAID Untlar penalties of perjury, I declare that the facts I have rope rted a~bfov p~Ie ra trw, c'~o-r7re~t and ^eomplat• to ~a best of_my knpe(~edpe and bell •f. HOME ( I ~ 1) ~ I ~~//1~ eT . J n //J'1 d 1 WORK C ) (jg AXP R SIGNATURE TELEPHONE NUMBER DATE PENNSYLVANIA INHERITANCE _ `INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES 'l 'L I AND PD eoX zaosol - ;~;','.'-`TAXPAYER RESPONSE HARRISBURG PA 17128-0601 - esv-uw sx afv ,oe-ou ;LERK OF °=RLA`d~ JACpUELIN HOLLAR 136 WOODS DRIVE MECHANICSBURG PA 17050 FILE NO. 21-~"~ 1D~ ACN 09152168 DATE OB-12-2009 EST. OF BONNIE M JONES SSN 191-24-6178 DATE OF DEATH 04-04-2009 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 TYPE OF ACCOUNT ® SAVINGS CHECKI N6 TRUST CERTIF. MEMBERS 1ST FCU provitlatl the Oepartwan4 rlth the inforaation bales, which has been used in calculakine the Potential 4ex due. Race rtls intlicata that at the death of the above-nawatl tlecetlent, you ware a ioint was r/banal ieiarv of this account. If you feel khe inf orwatien is incorrect, Please obtain written correction frow the financi el institution, attach a copy to this fora and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Cowwowealth of Pennsy lvsnie. Please call (]17) 787-832] with question s. COMPLETE PART 1 BELOW ^ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 230293-00 Account Balance Percent Taxable Amount Subjoet to Tax Tax Rate Potential Tax Du• Date 05-20-2003 Established g 7,461.26 X 16.667 $ 1,243.57 X .045 $ 55.96 To ansu re Proper cratlit to the account, two copies of this notice wust aeeowparo pavwant to the Register of Wills. Make chock pavabl• to "Register of Wills, Agent". NOTE. If to paywents era wade rithin th rea wonths of the decetlant's tlata of tlaath. tlatluet s 5 portent discoun[ on the tax due. A,ry Inhsrltancs Tv[ tlua rill baewa delinquent nine wonths of tar the tlate of tlaath. P T TAXPAYER RESPONSE ~ 1 A. ~ Tha above inforaation one tax due is eorract. Rewit paywent to the Rapiatar of Wills rith tro copies of this notiea to obtain CHECK a discount or avoid intareat, or chock box "A" and ra to rn this na tiea to the Register of r Wills antl an official assesswent will be issued by the PA Oepa rtwent of Revenue. I ONE ~ L BLOCK B. ~ Tha above asset has boon or will ba raportatl antl tax Paitl with the Pann sylvan is Inheritance Tax return ONL Y to be filed by Ohs estate rep rasentetive. C. ~ The above inf orwa ion is inea rract antl/or tlabts and tladuetions rare paid. Cowplata PART 2~ and/or PART 3~ bales. PART If indleatinp a difforont tax rato, pia aso stato Q relationship to docetlent: TAX RE TURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Oata Establlshetl 1 2. Account Balance 2 S 3. Percent Taxable 3 X 4. Amount Subiect to Tax 4 5. Debts antl Deductions 5 6. Amount Taxable 6 7. Tax Rat• 7 X 8. Tax Dua B PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID Untler penalties of p•r3ury, I tloclara that the facts I have reported a-~blav-1 era t/r~u/e,-e7o rra-~It and complete to the bast of my kn ledge and belief. HDME ( I ~ I ) ~e`I(' !~ [ WORK ( ) AXP R SIGNATURE TELEPHONE NUMBER D TE ~, =x ~3 I~ `~ `~Y, y ~ b t, ,..:;G..S.ii .,\ ~W V~ tlt C~ hn Y~ ~ ~. `_ / " > ~(`1~\(j~j~~J~ t~ ~.. ~~ ~+! `i" `~C~ ~ i --- `~ r / ~ ~/ ~ V' ~~ ~ `. { r n `'