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Home My WebLink About05-24-10COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: BURNS ROBIN L 405 MARION DRIVE LINGLESTOWN, PA 17112 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ACN ASSESSMENT CONTROL NUMBER fold ESTATE INFORMATION: ssly: i~4-2o-1659 FILE NUMBER: 2110-0539 DECEDENT NAME: MAILEY ROBERT N DATE OF PAYMENT: 05/24/2010 POSTMARK DATE: 05/22/2010 COUNTY: CUMBERLAND DATE OF DEATH: 04/19/2010 AMOUNT 10125683 ~ 54.66 TOTAL AMOUNT PAID: REMARKS: SEAL CHECK# 7378 INITIALS: CJ RECEIVED BY: 54.66 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REV-1162EXI11-961 N0. CD 012787 REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES PO BOX 280601 -- HARRISBURG PA 17128-0601 ,_.,_ ~ ,. REV-1543 EX AFP (OB-OB) PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE ~L .,~ AND FILE N0. 21 `;'~ ~ ~..1 - ` ' `P4XPAYER RESPONSE ACN 10125683 '-;; DATE 05-06-2010 E~40 ~i~~ ~~+ ~~i 1~J~ S t E ~r~i ^.r ARP { ' 4 ` J~.~. , t ((~`~~ ~ti ''.F r ~..•.l! r i~ tJl.f1-.-: _ . ROBIN L BURNS 405 MARION DRIVE LINGLESTOWN PA 17112 EST. OF ROBERT N MAILEY SSN 174-20-1659 DATE OF DEATH o4-19-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE 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 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 tail (717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 100727-00 Date 03-09-1988 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 $ 621 • 33 payable to "Register of Wills, Agent". Percent Taxable X 16.667 NOTE: If tax payments are made within three Amount Subject to TaX $ 1 O3 • 56 months of the decedent's date of death, Tax Rate )( .045 deduct a 5 percent discount on the tax due. Anv Inheritance Tax due will become delinquent Potential TaX DUe $ 4 • 66 nine months after the date of death. PART TAXPAYER RESPONSE FAILURE TO RESPOND-WILL RESiJL7' IN AN OF~IGIAL TAX '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 Wills and an official assessment will be issued by the PA Department of Revenue. C ONE 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 information 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 OFFICIAL llSE ONLY.. ~AAF relationship to decedent: PA DEPARTMENT. OF REVENUE TAX RE TURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD LINE I. Date Established 1 1 2. Account Balance 2 $ 2 3. Percent Taxable 3 X 3 4 T $ 4 4. ax Amount Subject to 5 - 5 5. Debts and Deductions 6. Amount Taxable 6 '~' ~ 7. Tax Rate 7 X 7 8. Tax Due 8 $ $ PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported above are true, correct and complete to the best of my knowledge and belief. HOME C ) WORK ( ) __--_---__ Tr, rr,,,r,ur u„unro neTr TOTAL CEnter on Line 5 or rax uompuca a one a °s ~ -~ ~:, ~:. fi W x ~ W ~/~`. ~~~~r=~ ~(~~O~'~Y 24 ~~~ ID- 51 _.~ _ $` r, ~ ~.- C~Er C ~ ; r ~~ OR~`~~~1 : ` ART Cl.~~ , ~~.~ . ~ 0, Pq ~ ~~ L ~ c%~ ~ ~~ ~ S ~ 4 ~ -~, ~ °~b. /) N., ~ ~ ` ~_ ,,~ ~ rJ ~~ i ~ ~ P-0 '~ J