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HomeMy WebLinkAbout11-09-09 (2)COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ACN ASSESSMENT CONTROL NUMBER NO. CD 01 1972 SIMONS LINDA L 335 MULBERRY DRIVE MECHANICSBURG, PA 17050-3141 -°----- fold REMARKS: CHECK# 102 INITIALS: DM SEAL RECEIVED BY: REGISTER OF WILLS REV-1162 EX(11-96) AMOUNT GLENDA EARNER STRASBAUGH REGISTER OF WILLS TOTAL AMOUNT PAID: $461.94 PENNSYLVANIA INHERITANCE T INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES PD Box 280681 AND HARRISBURG PA 17128-8681 TAXPAYER R E S P O N S E REY-1543 IX AFp (OB-087 FILE N0. 21- oq -q~p ACN 09161428 DATE 09-25-2009 TYPE OF ACCOUNT EST. OF PHILIP TOMLINSON SSN ^ SAVINGS 203-05-6555 DATE OF DEATH 09-15-2009 ^ CHECKING COUNTY CUMBERLAND ^ TRUST REMIT PAYMENT AND FORMS T(~ ~ © CERTIF. LINDA SIMONS 335 MULBERRY DRIVE REGISTER OF WILLS ~ p ° ~;, MECHANICSBURG CUMBERLAND CO COURT ~ ~ PA 17050 ~'•-' CARLISLE, PA ~k' •' 17013 s-r~ ~ O r, ~~ 7 =~ ~ -~ ~ .~ MEMBERS 1ST FCU c" iQ-c•7 provided the Department with the information below, which has be5n d~d in calralatin$"~ha"e"€ Potential tax due. Records indicate that at the death of the above-named decedent, ,~(^ 1 ~- •, It you feel the inforaation is incorrect, please obtain written correction from the financial institution, attach a cop o this fo' 7 and return it to the above address. This account is taxable in accordance with the Inharitance,Taxtlxseof the Comm n ohis IaC~)gnnt. Pennsylvania. Please call (717) 787-8327 with questions. COMPLETE PART 1 BELOW * h of ~` SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 314782-42 Date 08-26-2008 Established To ensure proper credit to the account, two Account Balance copies of this notice ^ust accompargr ~ 21, 597.1 7 pays®nt to the Resister of Wills. Make check Percent Taxable X payable to "Register of Wills, Agent". Amount Subject to Tax 50.000 ~ 10, 798.59 NOTE: If tax payments are made within three TaX Rate X months of the decedent's date of death, Potential Tax Due _ • 045 deduct a 5 percent discount on the tax due. ~` 'S ~o ~G! G 485 94 Any Inheritance Tax due will become delinquent PART nine ^anths after the date of death. 1^ TAXPAYER RESPONSE 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 CHECK a discount or avoid interest, or check box "A" and return this notice to the Register of ONE ~ Wills and an official assessment will be issued by the PA Department of Revenue. B L 0 CK B. ^ The above asset has been or will be reported and tax 0 NL Y to be filed by the estate representative. paid with the Pennsylvania Inheritance Tax return C• ^ The above informs ion is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART 3^ below. PART If indicating a different tax rate, please state relationship to decedent: TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Date Established I 2. Account Balance 2 $ 3. Percent Taxable g X 4. Amount Subject to Tax 4 $ 5. Debts and Deductions 5 6. Amount Taxable 6 $ 7. Tax Rate ~ X 8. Tax Due 8 $ PART .- . a DATE PAID PAYEE DEBTS AND DEDUCTIONS CLAIMED --• - =~~m ~ or rax Computation) Under penalties of perjury, I declare that the facts I have re templet to the be /~~y knowledge and ;belief. ported above are true, `~ 3 a- D TF Q Z ,. 3 n J~ ""t'1 rti.. Ie.~ ~ z ~ ,. "rn- ~.. £ ~ Y ` , ~`~lv,l F .. ti ~ i ~ r 20pg M~~, ~~ ~ ~ ~~ 's' ~ ~LER~C ~ r QR{~ ,. ~ CU ~ L nQUR~ ` .._ ~~ .. 1