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HomeMy WebLinkAbout11-23-09 (5)PENNSYLVANIA INHERITANCE TAX ~~ ~ ~ J~ ~ ~~ ~".1 J•-~ INFORMATION NOTICE / BUREAU OF IP+DIVIDUAL TAXES _ .. AND F I LE ND . 21 Po Box zBO6o1 TAXPAYER RESPONSE ACN 09141161 HARRISBURG PA 17128-0601 - - ~. ..- DATE 06-26-2009 REV-1543 EX AFP (OB-OB) ~l'~3 ~~ ra ~3 ~5~~ (~ ~ j rJ TYPE OF ACCOUNT EST. OF TINA M TRUMP ^ savlNGs i ~-r ~,~- ~ $$N 173-60-3523 ® CHECKING ` C,~ _;~,, ~~r DATE OF DEATH 06-08-2009 ^ TRUST COUNTY r - r r` CUMBERLAND ^ CERTIF. ~ qq '~~' fir ' REMIT PAYMENT AND FORMS T0: ROBERT E SHIELDS REGISTER OF WILLS 53 SME CUMBERLAND CO COURT HOUSE SHIPPENSBURG PA 17257 CARLISLE, PA 17013 MEMBERS ].ST FCU provided the Department with the information below, which has been used in calculating the potential 1: ax due. Records indicate that at the death of the above-named decedent, you were a point owner/beneficiary of this account. If you feell 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 (717; 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 287464-11 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 $ 411 .76 payable to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax payments are made within three Amount Subject to TaX $ 205 • 88 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 $ 30 • 88 nine months after the date of death. PART TAXPAYER RESPONSE FAILEIRE 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 re#urn 0 N L`f 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 OFFICIAL _USE ONLY AAE relationship to decedent: PA DEPARTMENT OF REVS U 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 '~ 6 7. Tax Rate 7 X ~ 8. Tax Due 8 $ $ PART DEBTS AND DEDUCTIONS CLAIMED 3^ DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported a'b7ojv+e7~are tr/ue, co`rr(}e~crJt and complete to the best of my knowledge and belief. HOME C / / / ~ ~~~~c~~125 / ~.~,''1j^ WORK ( J ~ ~~~~~ ~$~F~A TCI C~LJn AIC AIIIMRCD TOTAL (Enter on Line 5 of Tax Computation) S ALLIANCE HEMATOLOGY ONCOLOGY PA PO BOX 75083 Baltimore, MD 21275 (410) 876-5747 To TINA M TRUMP 53 SHIPPENSBURG MOBILE ESTRTES SHIPPENSBURG PA 17257 Date Description of Transaction 04/30/09 Prepayment .... Thank You Future Appointments TINA 05/22/09 TINA 05/22/09 Page 1 Statement Date 04/30/09 Account Number 13591.0 Amount -35.00 Previous Balance 17513.10 Today's Total -35.00 Total Due 17478.10 Total Due From Patient 35.00 9:45 OV & LAB 10:00 FOLLOW UP VISIT Ins ~~ee c(; i- r ~, j ~- ~ 6.; ` _- ~, ~a E" ".~' Cry ~ ~ f `~ ~ ~' c ~ ¢i E. f ~ ~ ~` t €. ~ T { r $ _ r .f .~ .tee ~ ~ ~~ ~~~=-~'~ ~ ~ ~ ~ i `~, ~ 5.~ ~ ~ :_. ~ ~ , cam' ~ ~~ ~ , _. } _ , _ . `.i _, ..~ _ ~ ~' r_ __ ; .~... _ -v ; oa' o - _. ~. -. - ~ .._i _ L0~-,. _ ~... J_ .15 )_.. __ _J~ e _ _ ~ -__~ ~ ~.._ - _1- -' ~ JIB' - ~, _ ~~ J i~_n ~ f = `=, tJ J --^-.T~~ 1 '7C.~ _Or~ir _._ T _ na ~'?ar i - Tr,,,~p - ~ecea~ed _. j~ireCt :r8iT13t1Gn fat i G,n;,; i de Guarantee rrograrn ~~crla~?:~'e Travel Pro~ec~~ori ?=cs=~=~~ TC`~' S?EC=---- ~~?A~KG~S ..~ L' t:' ~ !' ~ .. -. Ser°~ice_ ct Fem.~iera_ Darector =~~---- ~'= ~_ ~ --'~ICos~:,~ ~ i z ing r _~_es & L,.att nor lt~er~c.mial .~ervice -_r ~ auipmen° ~ o. ~;roT~or; a_ Service ~~_ _. ~riVat@ i~ Family VieWing }, i ~„es ~ ng the Cre-'at i cn ding oT ^reL:~a „ed ~~'="a' "'-~ "~ac;~:aU ~ngjForwar ~- Persaral Delivery of Cre?n~.tad Reiit3ins Sca~~ering o_ Cremated ?.e~nains ^C,TA;, J~ C~ESSIONAL SEkVICES AuTOh10T~'vE ~O~IPP'~ENT y Removal Vehicle Lea's- Carj Clergy Car C Faily ar SerV1Ce VerilCl2 TOTAL AliTOM~JTIVE EOU ~ F?~iEIQ^1 /1-!ate.?' S i' . ~ '~ TrC!u~C'~ S +L' . 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