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Home My WebLink About01-19-10COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT WALLACE YVONNE 143 SALEM CHURCH ROAD MECHANICSBURG, PA 17050 fold ESTATE INFORMATION: ssN: 546-5o-483s FILE NUMBER: 2110-0054 DECEDENT NAME: JOLY THERESA M DATE OF PAYMENT: 01 / 19/2010 POSTMARK DATE: 01 /14/2010 couNTY: CUMBERLAND DATE OF DEATH: 12/03/2009 ACN ASSESSMENT CONTROL NUMBER AMOUNT 09179993 ~ 519.24 TOTAL AMOUNT PAID: REMARKS: CHECK# 426488404 SEAL INITIALS: CJ RECEIVED BY: 519.24 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REV-1162 EX111-961 NO. CD 012243 REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES PO BOX 280601 HARRISBURG PA 17128-0601 PENNSYLVANIA INHERITANCE INFORMATION NOTICE r,,- -~,.,F . ,t .t ~~ .~ _ AND ' ,~ {4. ~.,;,T~IXPAYER RESPONSE REV-1543 IX 11FP Coe-08) ~a~o ~~~ ~ 9 ~~ 12~ ~-3 EST. OF THERESA M JOLY Cr~~~t~ (~~ SSN 546-50-4836 ~~'~ '~~~)~ DATE OF DEATH 12 - 0 3 - 2 0 0 9 (~~~1 p,_wfj ~ ~.. pA COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: YVONNE WALLACE REGISTER OF WILLS 143 SALEM. CHURCH ROAD CUMBERLAND CO COURT. HOUSE MECHANICSBURG PA 17050 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 ware a ]oint owner/beneficiary of this account. If you feel the infonation 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 (7171 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 197517-11 Date 10-05-2000 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 $ 854.92 payable to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax payments era made within three Amount Subject to Tax $ 427 • 46 months of the decedent's date of death, . 0 4 5 deduct a 5 percent discount on the tax due. Tax Rate X _ Any Inheritance Tax due will become delinquent Potential Tax Due $ 19.24 nine months after the date of death. PART TAXPAYER RESPONSE Q ,~ ;~N,. 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 CHECK Wills and an official assessment will be issued by the PA Department of Revenue. C ONE BLOCK B. ~ The above asset has been or will be reported and tax void 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: ~E..:< 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 DATE PAID PAYEE DEBTS AND DEDUCTIONS CLAIMED DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) 6 Under penalties of perjury, I declare that the facts I have reported at~bo1ve ar true, correct and complete to he best of mY kn(o~wledge and belief. HOME C l l~ ) ~~` ~~ ~~ ~~~u"~~„ W ~ Y °~- WORK C ) t rc) counNG NIIMRFR DATE T FILE N0. 21~ Il~-~5~ ACN 09179993 DATE 12-18-2009 ~ o y"~ ~ C'V f~!f NIl7• H ~ OOQ(O Z "~ ~; dr+ MPO r'r''N QQ~'r0 0 asoo z ~° N } ¢a o ~ ~ ___.__. M i~~ r -~ a' R„ ~ W~ ;g ~.,,„, n n 1 .,~ 0 m m 0 0 a a o- a 0 r ~~ ~, ' ), ~~ r ~, `j ._ f ~-1 1 `~' ZOlO JAt~ 19 P ~~ IZ' 43 ''4 f 1. ~, ~T t \ O~~ ~ > j, C~~,~.;_ '.` ado C~„ ~~' r 3~ nr/ l~ ..; 1 +s ~.i ~_ f4t t~ ~~.~ ~~