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Home My WebLink About11-23-09 (4)PENNSYLVANIA INHERITANCE T INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES - AN D PD Box zao6al ~ TAXPAYER RESPONSE HARRISCURG PA 17128-0601 REV-1543 E% AFP (OB-OB) t ~ ~" `~ Cf~ 7~ FILE N0. 21 ACN 09141160 DATE 06-26-2009 ~~~~ ~~~~ ~~ ~~ ~ ~ ~ 4 S EST. OF TINA M TRUMP CI~_~ r,~ SSN 173-60-3523 ~; ~ ,JiJ.`- DATE OF DEATH 06-08-2009 ' - -, p;~j COUNTY CUMBERLAND !~ i`,k_';, ~ `~ ~ ~ ~ ~ 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 liST 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 fee:L 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 C717) 7B7-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 287464-00 Date 06-19-2006 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 $ 1 , 936.81 payable to "Register of Wills, Agent". Percent Taxable )( 50.000 NOTE: If tax payments are made within three Amount Subject t0 TaX $ 968.41 months of the decedent's date of death, Tax Rate X lrj deduct a 5 percent discount on the tax due. Any Inheritance Tax due will become delinquent PotEtntial TaX DUe $ 145.26 nine months after the date of death. PART TAXPAYER RESPONSE FAILURE TCl RESPOND .`WILL RESULT IN AN C)FFICTAL TAX ASSESSMENT A. O 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 informs ion is incorrIe-~ct and/or debts and deductions were paid. / Complete PART 2~ and/or PART IJ below. If indicating a different tax rate, please state ~ PART relationship to decedent: TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS 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 / 6. Amount Taxable 6 '~ 7. Tax Rate 7 X 8. Tax Due 8 '~ PAD OFFZCIAL_tISE ONLY ~' AAF PA DEPARTMENT''OF REV N E 1 2 3 4 5 6 7 8 PART DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported a~byove are tru/e, c^orr(e-c7t and complete to the brlest of `my knowledge and belief. HOME C /j~ ) ~~[r,'"•~.[~X / ~/ (~ ~~ ~.~~ ..__.....~ TCI CP4.InNF NIIMRFR DATE TOTAL CEnter on Line 5 of Tax Computation) S ALLIANCE HEMATOLOGY ONCOLOGY PA PO BOX 75083 Page 1 Baltimore, MD 21275 (410) 876-5747 To: Statement Date I TINA M TRUMP j 53 SHIPPENSBURG MOBILE 04/30/09 ESTATES SHIPPENSBURG PA 17257 Account Number 13591.0 Date Description of Transaction Amount Ins 04/30/09 Prepayment .... Thank You -35.00 j Previous Balance 17478.10 Today's Total -35.00 Total Due 17443.10 Total Due From Patient 35.00 ruture Hppomtments TINA 05/22/09 9:45 OV & LAB ~ TINA 05/22/09 10:00 FOLLOW UP VISIT i i i _ ._ . - _. _ _ . a. ~ ~ ~. - .._ :~ ~ 'y -i ~ ... _ .. .. .. r C~. 4 .i ~_ .. _ .. e q.. ... ~_ ..., r-_ _ ,- r T~__. __ ._~,_ _ ei ~_~~.--- _, T"'- y -~ .. ~ i C ~. ~-. I ' _' r. i ~S fir _. _.. ':,i ... ~. i:" _.._ ... __ _.. ~ _ .. .~ J _ ." _ J .. .. ~. .... .. ~ _ ~ _. v7, ~ ._ ,. ~~~ 4 ~ "` ~ r1 ti J:f~ .. .:.. a7~i :r i.. ~':~ 3'1 ''4' _ G ~s ~~1r_ _ __ T. _ ... ~ . _ ti ., . _. .~ i~ ._ .. ;v~ "J `r~ y ^ _ _ ' ;, ~?.