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Home My WebLink About12-14-09COMMONWEALTH 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 6 DATE OF PAYMENT: 12/ 14/2009 POSTMARK DATE: 1 2/1 1 /2009 COUNTY: CUMBERLAND DATE OF DEATH: 09/15/2009 REV-1162 EX(11-96) NO. CD 012101 ACN ASSESSMENT AMOUNT CONTROL NUMBER 09170053 ~ 5309.45 TOTAL AMOUNT PAID: REMARKS: 5309.45 CHECK#123 INITIALS: DM SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIYIDI{A~'TA1(~'•~~'` I " '~ PO BOX 280601 ~ --° HARRISBURG PA 17128-0601'!'_ REY-1543 IX IIFP (08-OB) PENNSYLVANIA INHERITANCE T INFORMATION NOTICE AND TAXPAYER RESPONSE FILE N0. 21 09-0950 ACN 09170053 DATE 11-02-2009 "7 _ ~ _ TYPE OF ACCOUNT 1i11.i~ ..~a-~.i i •2 r. EST. OF PHILIP TOMLINSON ^ savINGs C(,.~RKUr SSN 203-05-6555 ^ CHECKING "~a~"~'-"~`S CCURT DATE OF DEATH 09-15-2009 ® TRUST . ` 1 ~~d CQ PQ COUNTY CUMBERLAND ^ CERTIF. ~~~: ~l !~/~A"Sj ~OYUS REMIT PAYMENT AND FORMS T0: BRANDY A BOLINGER REGISTER OF WILLS 1'-"^ ~° "~T^uSC CUMBERLAND CO COURT HOUSE PRAIR~EV~6~LFa ' A '"7GO-r't:. CARLISLE, PA 17013 ~~35 v~k~bE.r~ ~ ~r ~`Y1E ~• ft~ ~ c5 6~ ph ~ ~ vsv PNC BANK NA provided the Department with the inforeation below, which has been used in calculating the potential tax due. Records indicate that at the death of the above-naead decedent, you were a feint owner/beneficiary of this account. If you feel the inforeation is incorrect, please obtain written correction free the financial institution. attach a copy to this fore and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Coeeonwealth of Pennsylvania. Please call C717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 000031000330327 Date 09-15-2008 Ta ensure proper credit to the account, two Established copies of this notice Bust accoeparnr Account Balance 70 payment to the Register of Wills. Make check 7 238 " " , . payable to Register of Wills, Agent . Percent Taxable X 100.00 Amount Subject to NOTE: If tax payments are Bade within three 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. Potential TaX Due eI Any Inheritance Tax due will become delinquent ~ _ ~L. eZ~{ '_*='?'~*'! 3~~~ ~ ~ nine months after the data of death. 6A P T TAXPAYER RESPONSE ~ 1 ~'~ ~~ i~` s,, A~ A. {~ The above inforeation and tax due is correct. 1.(T Remit Davment to the Register of Wills with two copies of this notice to obtain CHECK a discount or avoid interest, or check box "A" and return this notice to the Register of C 0 N E ~ Wills and an official assessment will be issued by the PA Department of Revenue. B L 0 C K B. ^ The above asset has been or will ba reported and tax paid with the Pennsylvania Inheritance Tax return 0 N L Y to be filed by the estate representative. C. ^ The above informs ion is incorrect and/or debts and deductions were paid. Comvlete PART 2~ and/or PART 3^ below. PART If indicating a different tax rate, please state a relationship to decedent: TAX RETURN - COMPUTATION LINE 1. Date Established 2. Account Balance 3. Percent 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 1 2 +~ 3 X 4 $ 5 - 6 $ 7 X 8 ~ PART DEBTS AND DEDUCTIONS CLAIMED 0 DATE PAID PAYEE DESCRIPTION AMOUNT PAID TOTAL CEnter on Line 5 of Tax Computation) • Under penalties of perjury, I declare that the facts I have reported above are true, correct and ompl to to t best of my knowledge and belief. HOME G~'~ )'~j\S Q33Z ~ WORK C ) yZ ~o of X SIG TURE TELEPHONE NUMBER DATE ,a~~ --r a `_ ,~. ~_ ~~. ~:, $~ ; . ~4' {A ~:~~f. ~~ ` _ s}~r ~'i ~ jd ° ~4~..'` c»! ~i~ ~_,r , ~~~ `.~ :k ~~ C r- r ,. -a ~ u ttE t C' ~E~1~1 ~i..l: ~!~ ~s ~_..... 200 oEC ~ ~ are ~~= s g r ~~ 3 d ~~ ~~~ jr~ f{.3' {~ ~ .~j.~.y} 4«` i~~ .~