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Home My WebLink About12-02-09COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128.0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT SIMONS LINDA L 335 MULBERRY DRIVE MECHANICSBURG, PA 17050-3141 fold ESTATE INFORMATION: ssN: 203-05-6555 FILE NUMBER: 2109-0950 DECEDENT NAME: TOMLINSON PHILIP B DATE OF PAYMENT: 1 2/02/2009 POSTMARK DATE: 12/01 /2009 COUNTY: CUMBERLAND DATE OF DEATH: 09/15/2009 ACN ASSESSMENT CONTROL NUMBER AMOUNT 09170054 ~ 5309.45 TOTAL AMOUNT PAID: REMARKS: CHECK#120 SEAL INITIALS: DM 5309.45 RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REV-1162 EX(11-96) NO. CD 012061 REGISTER OF WILLS PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAN,TA9(E)5 ~^ ~-" AND FILE N0. 21 09-0950 PO BOX 280601 '9 l ~~~~_ TAXPAYER RESPONSE ACN 09170054 FWRRISBURG PA lnza,atal DATE 11-02-2004 REY-1545 IX AFP t88-08) ZQ09 DEC -2 PM {2.3$ o€~'s ~au~r CHRISTINA A PRUETT -38~s9 -S" DR OAKwO 6-2653 ~3~ ..b~~ arz EST. OF PHILIP TOMLINSON SSN 203-05-6555 DATE OF DEATH 09-15-2009 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING Xn TRUST CERTIF. PNC BANK NA provided the Department with the information below, which has been used in calculating the Dotential tax due. Records indicate that at the death of the above-named decadent, you were a ioint ownerJbeneficiarv of this account. If you feel the info nation is incorrect> please obtain written correction iron the financial institution, attach a copy to this faro 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) 787-8b27 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS PART Potential Tax Due Any Inheritance Tax due will become delinquent nine months after the date of death. A. ~ The above information and tax due is correct. Remit payment to the Register of Wills Mith two copies of this notice to obtain CHECK a discount or avoid i nterest, 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. C O N E ~ BLOCK B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return ONL Y to be filed by the estate representative. C. ~ The above informs ion 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 ~-~~, v 'T"'~`°' Y"? s relationship to decedent: i . "' ~ s` ' ~~ e r~ '~~ ! TAX RETURN - COMPUTATIDN OF TAX ON JOINT/TRUST ACCOUNTS '' '' '' ~~~~'~ ~~ a~° ` ~ ~~'° 5 ' ~ww~rwww LINE 1. Date Established 1 r, f, r ~;,. 2. Account Balance 2 $ ` ~~.xa;~, ,,rr~~aYsr~ ~,~~'~~~° y ~ ~Y~ `t~ ~; as _, 3. Percent Taxable 3 X .:;?~ ,,,,,,,,,,,,~;-= ~ ~¢`%~• ~~` 4. Amount Subject to Tax 4 ~ !} ~„~ ~b z;.'4'' u,~~o ~"f ,~y, wwr.wwww~wlww ` 5. Debts and Deductions 5 ~r~~~'~ ,;yfe,; 3 ~q`~i" ~ ~ - : =~ ~ 6. Amount Taxable 6 $ ~~, '{~ ' 7. Tax Rate 7 X 8. Tax Due 8 $ ~.S~w ~"~`... PART DEBTS AND DEDUCTIONS CLAIMED a DATE PAID PAYEE DESCRIPTION AMOUNT PAID Account No. 000031200333131 Date 09-15-2008 To ensure Proper credit to the account, two Esta6135hed copies of this notice rust acconpamr Account Balance 7 238.70 Payment to the Register of Wills. Make check ~ payable to "Register of Wills, Agent". Percent Taxable )( 100.00 NOTE: If tax payments are node within three Amount Subject to Tax ~` 7,238.70 months of the decedent's date of death, Tax Rate X , 045 deduct a 5 percent discount on the tax due. Under penalties of perjury, I declare that the facts I have reported above are truJe, correct and complete o the b of my knowledge and belief. HOME C ~Z ) LpL ~ ~l h~ woRK c ~ c Z J o p TAXPAYER SIGNATURE TELEPHONE NUMBER DATE f ~ ? 'S4S.{ '~ ry 'S SY -~~. ..~ r.,: ~.~ ~{,.. ~,,z~ {} :~~ ~' €`~ ~,~ {" 7~ ``~k, ~r..t (. '~~7 ; ~r t'•' ~~•~ ~~ j1 ~*;i }~F} j~;e .y..~ 1.~ i'~ .,.a .~ a a a ~~ 'v, ~~