HomeMy WebLinkAbout11-23-09PENNSYLVANIA INHERITANCE
INFORMATION NOTICE
BUREAU OF INDIVIDUAL TAXES _ _ AN D
Po Box zaa6ol TAXPAYER RESPONSE
HARRISBURG PA 17128-0601 - i
REV-1543 EX AFP (08-De) ~- '
TAX ~~ /~~ C ~^ t-'~ ;
(, r
FILE N0. 21
ACN 09141157
DATE 06-26-2009
L~„'~ ~~..~~#° ~`~ iil ° ~ ~ ~ ~ ~ EST. OF TINA M TRUMP
SSN 173-60-3523
' ~~ ~'``~ DATE OF DEATH 06-08-2009
f1 -1 -.
''`F _'_~- COUNTY CUMBERLAND
C~!', ~ '-'~-! REMIT PAYMENT AND FORMS T0:
ROBERT E SHIELDS REGISTER OF WILLS
53 SME CUMBERLAND CO COURT HOUSE
SHIPPENSBURG PA 17257 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 calculatins 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. Plaaso call (71?? ?87-832? with a!!estior.s.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT YNSTRUCTIONS
Account No. 251341-0 0 Date 09-21-2004 To ensure proper credit to the account, two
Established copies of this notice roust accompany
payment to the Register of Wills. Make check
Account Balance $ 1 , 800 • 33 payable to "Register of Wills, Agent".
Percent Taxable X 50.000
NOTE: If tax payments are made within three
Amount Subject to TaX $ 900 17 months of the decedent's date of death.
Tax Rate X 15 deduct a 5 percent discount on the tax due.
Any Inheritance Tax due will become delinquent
Potential Tax Due $ 135.03 nine months after the date of death.
PART TAXPAYER RESPONSE
0 FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX';ASSESSMENT
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
C H E C K Wills and an official assessment will be issued by the PA Department of Revenue.
C ONE
B L 0 C K 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. dThe above information is incorrect and/or debts and deductions were paid.
Complete PART 2~ and/or PART ~ below. ` ~~
PART If indicating a different tax rate, please state
relationship to decedent:
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD
LINE 1. Date Established 1
2. Account Balance 2 '~
3. Percent Taxable 3 X
4. Amount Subject to Tax 4
5. Debts and Deductions 5 7~
6. Amount Taxable 6
7. Tax Rate 7 X
8. Tax Due 8 `~
PART
nwrr Dorn PAVFF
OFFICIAL USE ONLY AAF
PA DEPARTMENT OF REVE E
1
2
3
4
5
6
7
8
DEBTS AND DEDUCTIONS CLAIMED
DESCRIPTION
AMOUNT PAID
Under penalties of perjury, I declare that the facts I have reported aboyvrye are (t~'rue, c+olr~yrecrt~ and
complete to the best of my knowledge and belief. HOME C ~{~ / ~ Q ~ d d~ l
s~ ~(~, - ~R ~ ~ WORK C ~
~x ~•• rGl FPI-If1NF NIIMRFR DATE
ALLIANCE HEMATOLOGY ONCOLOGY PA
PO BOX 75083
Baltimore, MD 21275
(410) 876-5747
Page 1
To:
TINA M TRUMP
53 SHIPPENSBURG MOBILE
ESTATES
SHIPPENSBURG PA 17257
Statement Date
02/27/09
Account Number
13591.0
Date Description of Transaction Amount Ins
02/27/09 Prepayment .... Thank You -35.00
Previous Balance
Today's Total
Total Due
Total Due From Patient
Future Appointments
TINA 03/19/09
TINA 03/19/09
'~ 13631.10
( ,
-35.00
13596.10
,,x`'35.00 ' ;./~ '
10:30 OV & LAB
10:30 FOLLOW UP VISIT