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Home My WebLink About10-26-10COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: TAMA M CAREY 10 MAKENZEE DRIVE CARLISLE, PA 17015 -------- fold REV-1162 EX(11-96) PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT N0. CD 013547 ACN ASSESSMENT AMOUNT CONTROL NUMBER ---------- -------- ESTATE INFORMATION: ssly: 000-00-0000 FILE NUMBER: 2110-1067 DECEDENT NAME: MELEDANDRI JOSEPHINE L DATE OF PAYMENT: 10j 26/ 2010 POSTMARK DATE: 10/26/2010 COUNTY: CUMBERLAND DATE OF DEATH: 1 2/08/2009 10114515 ~ $236.95 $236.95 TOTAL AMOUNT PAID: REMARKS: TAMA M CAREY ~<aoSA INITIALS: HMW RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES A N D PO BOX 280601 TAXPAYER RESPONSE HARRISBURG PA 17128-0601 REV-1543 EX AFP (OB-OB) ACN 10114515 DATE 03-12-2010 TAMA CAREY 10 MAKENZIE DRIVE CARLISLE PA 17015 TYPE OF ACCOUNT EST. OF JOSEPHINE L MELEDANDRI ® SAVINGS SSN 175 - 24 - 7535 ~ CHECKING DATE OF DEATH 12-08-2009 ~ TRUST COUNTY CUMBERLAND ~ CERTIF. REMIT PAYM ENT AND FORMS T0: REGISTER OF WILLS 1 COURTH OUSE SQUARE CARLISLE PA 17013 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 acco~!nt is taxable in accordance with the Inheritance Tax laws ar' the Ca~mmonwealth of Pennsylvania. Please call C717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 103898-00 Date 08-27-1988 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance $ 20 ~ 571.12 Payment to the Register of Wills. Make check payable to "Register of Wills, Agent". Percent Taxable X 50.000 Amount Subject to Tax ~- 10 ~ 285.56 NOTE: If tax payments are made within three months of the decedent's date of death, TaX Rate X ~ lj deduct a 5 percent discount on the tax due. Potential Tax Due ,y` 1 , 542. $3 Anv Inheritance Tax due will become delinquent nine months after the date of death. PART TAXPAYER RESPONSE 1 '::.........`:.:.:..:.::..::.:.~:..:.~................................. ~~~ "F"D ES~"DN SILL ~EUL'~ IR AN ~FFIDIA '~:AX :A:ENEN'~"; A. ^ The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain C H E C K a discount or avoid interest, or check box "A" and return this notice to the Register of 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 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 rat lease st ate ......~ relat' ions hi to de ced :.: P ent. 2 %f 7~' TA - X R ETU RN CO MPU TA TIO N OF T AX ON JO I NT/ TRU S T ACCO U LINE 1. Date Established 1 ~ + ~~ 2. Account Balance 2 $ ~l ~, ~~~~ f '~, 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 $ .- 5. Debts and Deductions 5 - U ~ 6. Amount Taxable 6 $ :<:.. ...:: .. .... 7. T :,::.:: ax Ra A to X ,..: .. ;:...... 7 ':~.< ... $ ' ...'. 8. T ax Due 8 3 PART DEBTS AND DEDUCTIONS CLAIMED 0 DATE PAID PAYEE DESCRIPTION eMni~ur earn L~ /~ ~ //.~ 2~ •073 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. ~ r., ~. _.._> HOME C ~7d 7 ) ~y.3 7 ~~y/ l C~11'v-c:;Y~ . ~ _ . `Ct J~t...~. , . WO R K (~J/ ~ ) .a7 ~1 ~ - _ ~ 3 ~' ~ ld a I'G TAXPAYER N TURE ~ ~- TELEPHONE NUMBER D TE Dugan Funeral Home, Inc. 111 South Main St. P.O. Box 393 Bendersville, PA 17306- Phone: (717)677-8215 Fax: (717)677-4354 0955 Tama M. Carey 10 Makenzee Dr. Carlisle, PA 17015 The Funeral Service for Josephine L. Meledandri 1. PROFESSIONAL SERVICES Services of Funeral Director/Staff Embalming 3. AUTOMOTIVE EQUIPMENT Vehicle to transfer remains to Funeral Home C . SPECIAL CHARGE S Direct Cremation Merchandise Cremation Urn Cash Advances Newspaper Notices - Out-of-town Clergy/Mass Offering Certified Copies cf the Death Certificate Total HISTORY 1, 6~)5. 00 695.00 2,390.00 $2,390.00 350.00 350.00 $2,740.00 250.00 __ _-- 250.00 $2,990.00 650.00 650.00 $3,640.00 100.00 200.00 E~0 . 00 __ ___ 360.00 $4,000.00 $4,000,00 __ Total Interest/Amount Received: 0.00 Total Outstanding Balance as of 12/17/2009 $4,000.00