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Home My WebLink About11-16-09COMMON DEPARTM BUREAU DEPT. 28 HARRISB RECEIVED FR L OF PENNSYLVANIA E O EVENUE OF I DI I UAL TAXES O6 UR 7128-0601 OM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT TOLAND LYNN M 1003 EAST COOVER ST MECHANICSBURG, PA 17055 fold ESTATE INFORMATION: SSN: 022-24-8798 FILE NUMBER: 2108-1 168 DECEDENT NAME: GORDON CATHERINE H DATE OF PAYMENT: 1 1 / 1 6/ 2009 POSTMARK DATE: 1 1 /14/2009 COUNTY: CUMBERLAND DATE OF DEATH: 10/23/2008 ACN ASSESSMENT CONTROL NUMBER AMOUNT 08164136 ~ 5238.97 TOTAL AMOUNT PAID: REMARKS: SEAL CHECK# 2238 5238.97 INITIALS: CJ RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REV-1162 EX(11-96) N O . C D 012000 REGISTER OF WILLS PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE ~t~, ~~ AND FILE N0. 21 08-1168 BUREAU OF INDIVIDUAL TAXES !' Po BOX 2@0601 ~ ''~ " ~- i-'TAXPAYER RESPONSE ACN 08164136 NARRISBURG PA 17128-0601 I',,~ i f' tt ~_ I: "~` ':~t,-, , DATE 12-26-2008 REV-154 IIFP (08-08) 2009 NOY 16 PM I2~ 33 rr C~~pL~~~~1+~ VF Of~~CVi1V,J C~t1~1 CUP~~~~?j~r~~,~~ C>n.• PA LYNN M TOLAND 1003 E COOVE ST MECHANICSBURG PA 17055 EST. OF CATHERINE H GORDON SSN 022-24-8798 DATE OF DEATH 10-23-2008 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 TYPE OF ACCOUNT SAVINGS ® CHECKING TRUST CERTIF. SUSQUEHANNA BANK provided the Department with the information below, which has bean used in calculating the potential tax due. Records indicate that at the death of the above-named decedent, you were a ]oint 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.',~s5rlvania. °lease csll !717) 7@7-8327 with sues*ions. rnwDIGTG PeRT 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 4600414709 .Date 08-29-2000 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 $ 10 , 620 • 89 payable to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax payments are made within three Amount Subject to Tax $ 5, 310 .45 months of the decedent's date of death, X .045 deduct a 5 percent discount on the tax due. Tax Rate Any Inheritance Tax due will become delinquent Potential Tax Due $ 238.97 nine months after the date of death. TAXPAYER RESPONSE PART .. ,,. _ A. ~ The above information and tax due is correct. 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 assesswent will be issued by the PA Department of Revenue. ONE C BLOCK B. ~ The above asset has been or will be reported and tax paid with the Pennrilvania Inheritance Tax return 0 N L Y to be filed by the estate ravresentative. C. ~ The above informs zon is incorrect and/or debts and deductions were Daid. Complete PART 2~ and/or PART ~ below. PART If indicating a different tax rate, please state =~ ~ ~~ relationship 2 to decedent: lyA . TAX RETURN - COMPUTATION LINE i. 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 $ PART TATL: DATT1 PeYFF DESCRIPTION AMOUNT PAID Under penalties of perjury. I declare that the facts I have reported above are tr/uer// correct ani eomplet to the best of my knowledge and belief. HOME C7/7 ) 7 C2 Cam' ~~~ S ~_ . WORK (7/'7 ~ C70I - 70 [/ S~ /l-/~-C)9' ___ _..__....~ TFI CP41(INF NUMBER DATE DEBTS AND DEDUCTIONS CLAIMED 1VIAL ltnier On Line n ~~ yaw w.„r...o~~..••.