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Home My WebLink About01-04-10PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIYIDUAL TAXES AND FILE N0. 21' ~0 _ GOO NARRISBURG6PA nlzB-o6o1 _ ,.`~~ ~ ;~~-~-~;~= ~J3'AXP~-YER RESPONSE ACN 09179999 r ~• ~ ; ~., DATE 12-18-2009 REV-155~~A~P (9~~) ~ ...ya__. 2010 JAN -4 PM I ~ 26 C~~~~ C~ ORPHAN'S GOURT CUMB~fi~~.~D C~U., PA LEONARD BOURINSKI 1171 BOILING SPRINGS RD MECHANICSBURG PA 17055 EST. OF JOYCE BOURINSKI SSN DATE OF DEATH 12-03-2009 CO[1NTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 TYPE OF ACCOUNT ® SAVINGS CHECKING TRUST CERTIF. MEMBERS 1ST FCU provided the Departwent with the inforwation below, which has been used in calculating the potential tax due. Records indicate that at the death of the above-pawed decadent, you were a point owner/beneficiary of this account. If you feel the inforwation is incorrect, please obtain written correction frow the financial institution, atRach a copy to this forty and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Cowwonwealth of Pennsylvania. Please call C717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INS7~RUCTIONS Account No. 190277-0 0 Date 01-14-2000 To ensure proper credit to the account, two Established copies of this notice ^ust accowpany Account Balance 914 64 paywent to the Register of Wills. Make check "' . payable to Register of Wills, Agent". Percent Taxable X 16.667 Amount Subject to Tax ~ 152 44 NOTE: If tax paywents are made within three ' . wonths of the decedent s date of death, Tax Rate ~( , 00 deduct a 5 percent discount on the tax due. Potential Tax Due • 0 0 Anv Inheritance Tax due will becowe delinquent nine wonths after the data of death. P T TAXPAYER RESPONSE ~ 1 : ~~ A. I,YThe above inforwation and tax due is correct. IICCJJ Rewit p~went 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 Wills and an official assesswent will be issued by the PA Departwent of Revenue. C 0 N E ~ B L 0 C K B. ~ The above asset has bean or will be reported and tax paid with the Pennsylvania Inheritance Tax return D N L Y to be filed by the estate representative. C. ~ The above inforwa ion is incorrect and/or debts and deductions were paid. Cowplete PART 2~ and/or PART ~ below. PART If indicating a different tax rate, please state `` relationship to decedent: TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Date Established 1 2. Account Balance 2 $ ,,,~,,, a ~ } t`~' 3. Percent Taxable 3 X ~M ? 4'~ '~ 4. Amount Subject to Tax 4 5. Debts and Deductions 5 - ,'~ ~s`'~ f v~~~ 3' 'K~ °~~~~ je°F ~~'`,r~~r?, 6. Amount Taxable 6 ~ ~d r,',- R'~~~~i 7. Tax Rate 7 X 8. Tax Due 8 $ '.~ PART DEBTS AND DEDUCTIONS CLAIMED 0 DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported ab ve are tru e rrect a ~ ~~ ~mplete to t be of owledg~ and b li~ f. HOME ( ~l ~) ~ QQI "'° WORK C ) ,XPAYER SIGN TELEPHONE NUMBER DATE TOTAL (Enter on Line 5 of Tax Computation) 4 BUREAU OF INDIYIDUAL TAXES PO BOX 280601 HARRISBURG PA 17128-0601 ~`-•' REY-1543 IX AFP (OB-00) PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE ~,-rf~~'~. ;""!~ AND FILE N0. 21r~U''(~Ub2 ;, ; ;;TAXPAYER RESPONSE ACN o9' 80002 " ~°~ DATE 12-18-2009 2010 JAN -4 PM I ~ 26 CLERK C~ QRPHAN`S ~uURT CUMPERL~'~D CC1., PA. LEONARD BOURINSKI 1171 BOILING SPRINGS RD MECHANICSBURG PA 17055 EST. OF JOYCE BOURINSKI SSN DATE OF DEATH 12-03-7009 GOUNTY CUMBERLAND!' REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST ® CERTIF. 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 point owner/beneficiary of this account. If you feel the information is incorrect, please obtain written correction from the financial institution, attach a coDY 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 L717) 7E7-83tTwith ttuestioBS. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 190278-42 Date 01-14-2000 Ta ensure proper credit to the account. two Established copies of this notice must accompany payment to the Register of Wills. Make check Account Balance $ 5,486.02 payable to "Register of Wills, Agent". Percent Taxable X 16.667 NOTE: If tax payments are made within three Amount Subject to Tax $ 914.35 months of the decedent's data of death, Tax Rate ~( , 00 deduct a 5 percent discount on the tax due. Any Inheritance Tax due will become delinquent Potential Tax Due $ .00 nine months after the date of death. P RT TAXPAYER RESPONSE A 1 A. ~fhe above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain CHECK a discount or avoid interest, or check box "A" and roturn this notice to the Register of C 0 N E ~ Wills and an official assessment will ba issued by the PA Department of Revenue. 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. ~ 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 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) 4 Under penalties of perjury, I declare that the facts I have reported abov~e,ra~re~~true,~tcorrec}tom and co o best of my knowle a and belief. HOME C ~ [L ) ~Q'~ ~~y" ~~ ~, w ~~ i WORK C ) TAXPA`ER S NATURE TELEPHONE NUMBER DATE BUREAU OF INDIVIDUAL TAXES l;` PO BOX 280601 - HARRISBURG PA 17128-0601 t ~`'~i ~~' REY-15W IX AFP (OB-OB) PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE -, ~..,.. AND FILE N0. 21~~U-~~ ~- `^ "`l'~/~~PAYER RESPONSE ACN 09180000 ,,, '~f'` .ry DATE 12-18-2009 2010 JAM -4 Pty i = 26 TYPE OF ACCOUNT EST. OF JOYCE BOURINSKI ® SAVINGS n ~C~.ERK CF SSN ^ CHECKING c~r~~,5 ~O~j DATE OF DEATH 12-03-2009 ^ TRUST ~y~ t~~, ry COUNTY CUMBERLAND ^ CERTIF. IrUN~~~~V'yV vr~•. ~~ REMIT PAYMENT AND FORMS T0: LEONARD BOURINSKI REGISTER OF WILLS 1171 BOILING SPRINGS RD CUMBERLAND CO COURT HOUSE MECHANICSBURG PA 17055 CARLISLE, PA 17013 MEMBERS 1ST FCU provided the Department with the information below, which has been ysed in calculating the potential tax due. Records indicate that at the death of the above-named decedent, you were a joint owner/beheficiary of this account. If you feel the information is incorrect, please obtain written correction from the financial institution, attach a copy to this fora and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of t'he Commonwealth of Pennsylvania. Please call C717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 190278-0 0 Date 01-14-2000 To ensure proper credit to the account, two Established copies of this notice oust accompa(sy Dayment to the Register of Wills. Make check Account Balance $ 947.14 payable to "Register of Wills, Agent". Percent Taxable X 16.667 Amount Subject to Tax $ 157 86 NOTES If tax payments are wade within three ' . months of the decedent s date of death, Tax Rate ~( , 00 deduct a 5 percent discount on the tax due. Potential Tax Due $ 00 Any Inheritance Tax due will become delinquent • nine months after the data of death. P r TAXPAYER RESPONSE ~ 1 . A. I/Ylhe above information and tax due is correct. W Resit payment to the Register of Wills with 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 0 N E ~ 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. ^ 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 # ~ ~'~~ relationship to decedent: ~~'~ ~~ . ~ TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS ''~ e LINE 1. Date Established 1 $ ~ ~ '~ i` 1~ ~+ ~? =' al rr, 2. Account Balance 2 a , i,, , ,~~ 3. Percent Taxable 3 X ~r~~a?~"+`;~7~~,t'° q` ~~~.~(~ ~ r ~P'r ,,,~ ~~ 4. Amount Subject to Tax 4 $ ~ ~ 5. Debts and Deductions 5 - ~ - ~ : 6. Amount Taxable 6 $ ^ " ~~'~'1`+~° ~~~~~ '~~; ~'~~~`~ ~~__• 7. Tax Rate 7 X wMwirXw~WWW „4,., 8. Tax Due 8 $ ,: ~, ~~ PART DEBTS AND DEDUCTIONS CLAIMED TOTAL (Enter on Line 5 of Tax Computation) S Under penalties of perjury, I declare that the facts I have reported abovefjare /tyrue,'c trot and tom a to the be my knowledge and belie ~ HOME C ~/ ) ~~~" ~~.~~ e WORK C ) TA AYER SIGNATU TELEPHONE NUMBER DATE DATE PAID PAYEE DESCRIPTION AMOUNT PAID