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Home My WebLink About07-25-11COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: REV 1 162 EX(1 1-96) PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 014760 CLINE DIANE E 525 LAVINA DR MECHANICSBURG, PA 17055 -------- fold ACN ASSESSMENT AMOUNT CONTROL NUMBER ESTATE INFORMATION: SSN: 292-44-1006 FILE NUMBER: 211 1-0603 DECEDENT NAME: CLINE MARILYN A DATE OF PAYMENT: 07/ 25/ 201 1 POSTMARK DATE: 07/23/201 1 COUNTY: CUMBERLAND DATE OF DEATH : 04/ 30/ 201 1 1 1 132276 ~ $1, 230.34 TOTAL AMOUNT PAID: REMARKS: $1,230.34 CHECK# 784 INITIALS: DB SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAX ,~,., ~, ._ _ PO BOX 280601 ~r{ ( ;> , ~ -.- r HARRISBURG PA 17128-0601,~l, ,, , ~'~'-~ ~- -~ ~R6V-154,3 EX.'AFP ~0 ~08) ~~1L ~: i ~" G ~ t U ~~Eni\ ~r QRPf~,~J`S ~~(~Rt ~U~fP~PI ~~.~Yl~~ r'~ . PA DIANE CLINE 525 LAVINA DRIVE MECHANICSBURG PA 17055 PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE AND TAXPAYER RESPONSE FILE N0. 21 -'~ _~G~ ACN 1113227b DATE 05-11-2011 EST. OF MARILYN A CLINE SSN 292-44-1006 DATE OF DEATH 04-30-2011 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 tP~e 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 call (717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 175387-0 0 Date 04-18-1998 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 $ 54,681.6iD payable to "Resister of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax payments are made within three Amount Subject to Tax $ 27, 340.80 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 $ 1 , 230.34 nine months after the date of death. PART TAXPAYER RESPONSE FAILURE'TO RESPOND WILL RESULT IN AH OFFICIAL 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 C H E C K a discount or avoid interest, 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. 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. ~ "fhe above informs ion is incorrect and/or debts and deductions were paid. Complete PART ~ and/or PART ~ below. PART If indicating a different tax rate, please state OFFICIAL USE ONLY ~ AAF relationship to decedent: PA DEPARTMENT OF REVENUE TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS pA~` LTNE 1. Date Established 1 1 2. Account Balance 2 $ 2 3. Percent Taxable 3 X 3 4. Amount Subject to Tax 4 $ 4 5. Debts and Deductians 5 - 5 6. Amount Taxable 6 7. Tax Rate 7 X 7 8. Tax Due 8 $ g PART DEBTS AND DEDUCTIONS CLAIMED 3^ DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported above are true, correct and c o mplete to the best o f my knowledge and belief . HOME ( ~ i7 J ~ ~~ ~E"~ Z'~ QQ~~ F~ '' ~ ,,~ ~ OV~lZ. ~ l''~-`~- WORK C ~i 7 D ~ `~o " ~ ~~5~ ~ZC~'~ `Z3~ 2ut~ TAXPAYER SIGNATURE TELEPHONE NUMBER DATE TOTAL (Enter on Line 5 of Tax Computation) $ 'c„-. f~ '' Y ~. ~l 4~, ~ n ,.~ ~ '~ "~ ~ ~? / • ~ + ~ /O ; ~s r ,. ~ -~ c U~ (J`~ (~ ~b ~ ~ ~:~: ~~~k ~ ,_.,. ~ cJ' {~ ~ ~ ~ ~~t ~ ~~'• ~._ -1 d G s %h ~ ~ ,3? r° ~ ~' 7 ~ ~~ ~ ~~ ~ ~ . .~~ ,t, :.~ r -~ M M ~, .,. Y.M. ~..~.....,+ .Jt .. ~~~^~F~lV Jri ~~~~~a '~ ~ ~ ~i~Jl~ ' '~ ~,.,, .. ~ ' !. ~~ d ~, ., - - 1 sv -1 is vsn Wx ~~ ~__.~~