HomeMy WebLinkAbout11-23-09 (6)PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE ~( ~~'`~ ~ ~~~ ^
BUREAU OF INDIVIDUAL TAXES - _ AND FILE ND. 21
PD BOX 2811601 ~ ~7`AXPAYER RESPONSE ACN 09141162
HARRISBURG PA 17128-0601
~~ -
DATE 06-26-2009
REV-1543 EX AFP(OB-b8) ~"
TYPE OF ACCOUNT
LI~;~ ~~''~ ~J ~~}~ (~ ~ ~ ~
EST. OF TINA M TRUMP ® SAVINGS
SSN 173-60-3523 ^ CHECKING
r ~ ^
_.-
~
DATE OF
DEATH 06-08-2009 TRUST
^
~ti~'t'
';~i COUNTY CUMBERLAND ^ CERTIF.
fa. REMIT PAYMENT AND FORMS T0:
R~DBERT E SHIELDS REGISTER OF WILLS
53 SME CUMBERLAND CO COURT HOUSE
SHIPPENSBURG PA 17257 CARLISLE, PA 17013
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 0717) 787-8327 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 287464-05 Date 04-20-2007 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 $ 10,050.96 payable to "Register of Wills, Agent".
Percent Taxable X 50.000
NOTE: If tax payments are made within three
Amount Subject to TaX $ 5, 025.48 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
Potential TaX Due $ 753.82 nine months after the date of death.
PART TAXPAYER RESPONSE
0 FAILURE TO RESPt3ND wLLL RESULT IN AN OFFICIAL TA7C 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
f Wills and an official assessment will be issued by the PA Department of Revenue.
ONE
B L D 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 incorrte-ct1 and/or debts and deductions were paid.
Complete PART 2^ and/or PART IJ below.
1I
PART
0
TAX
LINE
If indicating a different tax rate, please state
relationship to decedent:
RETURN - COMPUTATION
1. ]Date Established
2. ,Account Balance
3. IPercent 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 IPAD
1
2 $
3 X
4 $
5 - r ~% ~C
6 $
7 X
8 $
OFFICIAL USE ONLY AAF
PA DEPARTMENT OF REVS U
1
2
3
4
5
6
7
8
PART DEBTS AND DEDUCTIONS CLAIMED
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
Under penalties of perjury, I declare that the facts I have reported a+b~ove are true), corlrec(ty and
complete to t~he(~best of my knowledge and belief. HOME C / ! I ) ~ ~ la7 w~ ~ E 7
~.~ - J'~ ~1.~~ ~ W O R K C ) L C~ ~.
1 ~+ .,~ '
f~ TCI CPIJ (1MG IJIIMAGR neTF
TOTAL CEnter on Line 5 of Tax Computation) S
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
05/22/09
Account Number
13591.0
„._. ~..
uate uescnpuon or i ransacuun ~~~~~u~~~ ~~~~
05/22/09 Prepayment .... Thank You -35.00
Previous Balance 7730.10
Today's Total -35.00
Total Due 7695.10
Total Due From Patient 70.00
Future Appointments
TINA
TINA
05/29/09 9:30 CHEMOTHERAPY ONLY
06/19/09 10:00 FOLLOW UP VISIT
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