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HomeMy WebLinkAbout11-23-09 (3)PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES '" ,'"°: '-:"~ .( A N D PD Box 2Ba6ol TAXPAYER RESPONSE HARRISBURG PA 17128-0601 REV-1543 EX AFP (0e-OB) ' ~~f~-~ ~~ ~~s ~ FILE N0. 21 ACN 09141159 DATE 06-26-2009 EST. OF TINA M TRUMP r, ;-,.-, , ,-„- SSN 173-60-3523 '`~I DATE OF DEATH 06-08-2009 r ,~ ~ n-r ~~'' `~ COUNTY CUMBERLAND C~.'' - - ' . °r. 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 calculating the potential tax due. Records indicate that at the death of the above-named decedent, you were a joint 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. Please call C717i 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 285813-05 Date 04-25-2008 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance $ 6 040 62 payment to the Register of Wills. Make check " , . payable to Register of Wills, Agent". Percent Taxable X 50.000 Amount Subject to TaX $ 3 020 31 NOTE: If tax payments are made within three ' , . months of the decedent s date of death, Tax Rate X 15 deduct a 5 percent discount on the tax due. Potential Tax Due g 453.05 Any Inheritance Tax due will become delinquent nine months after the date of death. PART TAXPAYER RESPONSE 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 co pies of this notice to obtain C H EC;K a discount or avoid interest, or check box "A" and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. ONE: B L O[;K B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return 0 N L Y ~o be filed by the estate representative. C. The 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 OFFICIAL tLSE ONLY ' AAF relationship to decedent: PA DEPARTMENT OF REVEN TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD LINE 1" Date Established 1 1 2. Account Balance 2 $ 2 3. Percent Taxable 3 X 3 4. Amount Subject to Tax 4 $ 4 5. Debts and Deductions 5 - ~ ~ 5 6. Amount Taxable 6 '~ 7. Tax Rate 7 X 7 8. Tax Due 8 $ $ PART DEBTS AND DEDUCTIONS CLAIMED 3^ TOTAL CEnter on Line 5 of Tax Computation) S Under penalties of perjury, I declare that the facts I have reported a b o v e are true, correct and complete to the best of my knowledge and belief. ~ j r 7 / HOME C /b ! ) giC, - .~~~7 "J ~ ~~ WORK ( ) [~ 't'7~ TAYDAVCD C7f`IJA TIIDC TCI CPUl1MC MIIMRCD T1ATC DATE PAID PAYEE DESCRIPTION AMOUNT PAID ALLIANCE HEMATOLOGY ONCOLOGY PA PO BOX 75083 Baltimore, MD 21275 (4101 876-5747 Page 1 To TINA M TRUMP 53 SHIPPENSBURG MOBILE ESTATES SHIPPENSBURG PA 17257 Statement Date 03/19/09 Account Number 13591.0 Date Description of Transaction Amount Ins 03/19/09 Prepayment .... Thank You -35.00 Previous Balance 13666.10 Today's Total -35.00 Total Due 13631.10 Total Due From Patient 35.00 Future Appointments TINA 04/16/09 10:30 FOLLOW UP VISIT . _.,.~ _ ~~~:a:3 _ . ,.. - ~ . __. 1\ ~, ,_ .a _ '~ tf _ _ _ ~i ,. _. .. ~ , _ _ _ _ ~ ... -~t___ _ .~ j Trt _. '.`f L71 i{11:'}x- _ ,- (- 4-L'~. .: _. ~.. _ v~(lt~"".a .._ rte. .. _~~ .., ~"Y~Sy"+(~, T ~: yY f~..~`v ~~} .. _. .. "_'$ .. _.~. _. _ _ , r r ~~ .-. ~g-;~ _. .. _, _ _ ,~ J;~ ~f ?' _ ir5 ~.1 a _ 3 .,., t r . ._ _ ....~ e: ~~ ~ ~a L ~ 1 ~'~ ~~ ~ ., _ _ ... ._ z .~ W _ 1" a >_ _ ~ ~ _. . _.. . ' i °~~'~' __ ~v~; _~'~ ~^ ~~_ -~' ~~»'v _ ~P :. ._ .L...~ _.tvL_. _._ a`l~"i. _ _ LJ , y ~ C y'~ _ .. .i ~, _.._ .... ~. t.: ... ,_~ ~ 'z.~ :'~ i1l . l~ ~~ .5 -?' ` r) `y' b v ,.... ~ ~ j ~ .. ,.. r ..~ .. ~` ._. lu~4L1V 1 ~i'`/~. ,. SM i ~J~e ._..J 1' T i". L.e~ ^1 .~a _.J ~~`~.'~6tS~ t^. .~..~? ~,.,.. .n,4_a~ }