HomeMy WebLinkAbout11-09-09COMMONWEALTH 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
SIMONS LINDA L
335 MULBERRY DRIVE
MECHANICSBURG, PA 17050-3141
(old
ESTATE INFORMATION: SSN: 203-05-6555
FILE NUMBER: 2109-0950
DECEDENT NAME: TOMLINSON PHILIP B
DATE OF PAYMENT: 1 1 /09/2009
POSTMARK DATE: 1 1 /06/2009
couNTY: CUMBERLAND
DATE OF DEATH: 09/ 1 5/2009
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
09161429 ~ 5129.33
TOTAL AMOUNT PAID:
REMARKS:
SEAL
CHECK# 101
5129.33
INITIALS: DM
RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REV-1162 EX(11-961
NO. CD 01 1973
REGISTER OF WILLS
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE ~~7 ''
BUREAU OF INDIYIDUAL TAXES AND FILE ND. 21 ~- ~`1- -`~~
PO BOX 280681 TAXPAYER RESPONSE ACN 09161429
HARRISBURG PA 17128-0601 DATE 09-25-2009
rev-isaa oc ~r coe-oe~
TYPE OF ACCOUNT
EST. OF PHILIP TOMLINSON ^ SAVINGS
SSN 203-05-6555 ^ CHECKING
DATE OF DEATH 09-15-2009 ^ TRUST
COUNTY CUMBERLAND ~ CERTIF.
REMIT PAYMENT AND FORMS T0:
LINDA SIMONS REGISTER OF WILLS c
335 MULBERRY DRIVE CUMBERLAND CO COURT HOUS~ ~,
~°~. J ` 1
MECHANICSBURG PA 17050 CARLISLE, PA 17013 _ ~ `~' r"
+s "`
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MEMBERS 1ST FCU provided the Departoent with the information below, which has been u -aCBlculg thr ~..}
potential tax due. Records indicate that at the death of the above-named decadent, you were a ]oint owner/be ary of t accauPt -r'~
If you feel the information is incorrect, please obtain written correction from the financial institution, attap copy to~his fRrAF ~~
and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of Commonwealth•of i
Pennsylvania. Please call C717) 787-8327 with questions. ~' ~--~-~
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 314782-43 Date 09-27-2007 7o ensure prover credit to the account, two
Established copies of this notice oust accoepany
payment to the Register of Wills. Make check
Aecount Balance $ 6, 050.73 payable to "Register of Wills, Agent".
Percent Taxable X 50.000
NOTE: If tax payments are ^ade within three
Amount Subject to Tax $ 3, 025.37 months of the decedent's data of death,
t
R
T X . 045 deduct a 5 percent discount on the tax due.
e
a
ax Any Inheritance Tax due will become delinquent
Potential Tax Due ~ ~ y t~~j, ~3 `~'4 nine months after the date of death.
PART TAXPAYER RESPONSE
A. The above inforoation and tax due is correct.
Rea it 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 assesswant will be issued by the PA Departoent of Revenue.
ONE
C
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. ^ Tha above informs ion is incorrect and/or debts and deductions were paid.
Cooplete PART ~2 and/or PART 3^ below.
PART If indicating a different tax rate, please state
relationship to decedent:
TAX RE TURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
LINE 1. Data Established 1
2. Aecount Balance 2
3. Percent Taxable 3 X
4. Amount Subject to Tax 4 $
5. Debts and Deductions 5 -
6. Amount Taxable 6
7. Tax Rate 7 X
8. Tax Due 8 $
PART
DEBTS AND DEDUCTIONS CLAIMED
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
comp to to the est of my knowledge and belief. HOME C «) ~4-~ ~ ~~~
~~ ~/~ WORK ( ) ~ ~ ~ d
r~~ ~vrn c.rn~ r„or TFI FPHfINF NUMBER DATE
DATE PAiD PAYEE DESCRIPTION AMOUNT PAID