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Home My WebLink About07-18-11COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT WELLER AMY L 902 SHEFFIELD AVE MECHANICSBURG, PA 17055 -------- fold ESTATE INFORMATION: SSN: 578-24-8866 FILE NUMBER: 211 1-0794 DECEDENT NAME: MITCHELL MABEL M DATE OF PAYMENT: 07/ 1 8/201 1 POSTMARK DATE: 07/15/201 1 COUNTY: CUMBERLAND DATE OF DEATH: 05/29/201 1 REV-1162 EX~11-96) N0. CD 014729 ACN ASSESSMENT AMOUNT CONTROL NUMBER 11145598 ~ 548.90 TOTAL AMOUNT PAID: REMARKS: 548.90 CHECK# 3380 INITIALS: HMW SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS ~~` PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE FILE N0. 21~"~~~~~9~ BUREAU OF INDIVIDUAL TAXES ~ -t-;~~" Po eox z8o6ol e dt'`1~.=-~'!1,~, ~ AND p ~, ~ ACN 11145598 HARRISBURG PA 17128-0601 DEPA T >=KrpF,~E~eNgE - r ~,5,}j~ j C TAXPAYER RESPONSE ~, ~..~.~.1 DATE 07-08-2011 REV -15~3,~~,AFtL~ f 05-'11) ~$ i". ' ~~+~ ~. ,` '~ JUG. ~ ` ` ' ' ~~~~ COURT d~~` ~l)~1~~R~~ C~.. PA AMY WELLER 902 SHEFFIELD AVENUE MECHANICSBURG PA 17055 EST. OF MABEL M MITCHELL SSN 578-24-8866 DATE OF DEATH 05-29-2011 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. MEMBER S 1ST F C U provided the department with the information below, which was used in calculating the inheritance tax due. Records indicate that at the death of the above named decedent, you were a joint owner/beneficiary of this account. If you are the Spouse of the deceased and any amount other than zero is reflected below on the Potential Tax Due line. note no tax may be due, but you must notify the department of your relationship to the deceased by checking Box C in PART 1 below and writing "spouse" in PART 2. If you believe he information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return it to i;he abuve address. Please call 717-787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 44443-44 Date 09-29-2006 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 ~{` 2, 287.47 payable to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax payments are made within three Amount Subject to Tax ~` 1 , 143.74 months of the decedent's date of death, Tax Rate X .045 deduct a 5 percent discount on the tax due. Any inheritance tax due will become delinquent Potential Tax Due ~` 51 • 47 nine months after the date of death. PART TAXPAYER RESPONSE 0 e \ \ ~ `:~ 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 return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. 0 N E BLOC K B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania inheritance tax return 0 N L Y filed by the estate representative. C. ~ The above informs zon is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART 3~ below. PART If indicating a different tax rate, please state ~ ~" ~\ relationship to decedent: , ~ ` TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS ~. ~ \\`'~~~~,"~~'` ~~ LINE 1. 2. 3. Bate Established i Account Balance 2 Percent Taxable 3 $ X \\` \~ \\ ~~ ~ ~ \ \ 4. Amount Subject to Tax 4 5. Debts and Deductions 5 - \ \ 6. Amount Taxable 6 $ \ ~ ~~ 7. Tax Rate 7 X 8. Tax Due 8 $ \~ ~~ \ PART DEBTS AND DEDUCTIONS CLAIMED 3^ DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I reported above are true, correct and co lete to the est f y knowledge and belief . HOME C ~~ 1 ) ~~ Q woRK c ~ N,~- TAXPAYE SI NATURE TELEPHONE NUMBER DATE TOTAL CEnter on Line 5 of Tax Computation) S _,,~„ ~,. USA F1R57,C..A55 r S '~ ~j `t .. ~•~ ~ ~a, r. J r J ~(... ~` i. ~ 5 ~ fp•. c ' } s 4 i. ~ . ~1. la.. • .~ .~.~ ' V ~' r (~ ~.a .,~ ,'~, '~'"~. . .r.^ J :' .':~ '/ ~~ w i' V V =~ • ~ ~.~ -- U~- ~- " ~ .. U w t ~ ~ ~~' ~~ 0 "tea I °'v ~° a ~, ~ ~ 353 a~ W r yN ~ ~~~ Q- ~~i' ~ L, ~ ~cnz ~~~ U~ ~~ C~ ~ (~ v ~~ 1}f ~~1 ~;E sT~ ~...: .,..}