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Home My WebLink About07-25-11 (2)COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: REV-1162 EX~11-96) PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT CLINE DIANE E 525 LAVINA DRIVE MECHANICSBURG, PA 17055 -------- fold 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 AMOUNT ACN ASSESSMENT CONTROL NUMBER 11132277 ~ $78.82 I 1 TOTAL AMOUNT PAID: REMARKS: DIANE CLINE CHECK# 783 SEAL $78.82 INITIALS: WZ RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS N0. CD 014758 REGISTER OF WILLS __ _ _ PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES ;'~',• A N D Po Box 280601 `TAXPAYER RESPONSE HARRISBURG PA 17128-0601 ii}}~~,, 11~~{{irri~-~__ REV-1543 EJQ~~'(`S8i Q6~ t vl ' , ,...•. •+ FILE NO. 21^ f ~ - ~'~~ ACN 11132277 DATE 05-11-2011 ~~~ ~ ~ ,Ut~ ~~ '~ ~ 1~ ~ ~'L CLERK ~ OURT OPPH~I~ S , .~ Ctlt~~~a~.~_~~'~ . ~ CO.. PA DIANE CLINE 525 LAVINA DRIVE MECHANICSBURG PA 17055 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 1'7013 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 call (717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 175387 -11 Date 07-19-1999 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 $ 3, 502.90 payable to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax payments are made within three Amount Subject to Tax ~` 1 , 751.45 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 $ 78 • 82 nine months after the date of death. PART TAXPAYER RESPONSE ~~ \ \ \ o ~ A. ~ The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain CHECK 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. ~ The above informa ion is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART 3~ below. PART If indicating a different relationship to decedent. tax rate, please state ~ \~ ~ ~ \ ~ ~ ~ TAX RE TURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS O :~ ~~ ~ \\ \ ~ \ LINE 1 . i7ate Established 1 ~\ ~\\ \ ~ ~ ~~ ~~ ~ ~~~~ ~~~ ~ ~ ~ ~ 2. Account Balance 2 $ \~ ~ \ ~ a 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 $ \ \ ~ ~ \ ~ \ ~ 5. Debts and Deductions 5 ~ \~ ~ ~ \ 6. Amount Taxable 6 $ ~ ~~. ~ 7. Tax Rate 7 $ ~~ ~ ~ ~ ~~~ 8 . 8 Tax Due . ~~~\ ~~o ~ ~ ~ ~ ~~ \~ ~ .o~ PART DEBTS AND DEDUCTIONS CLAIMED a DATE P AID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported above are tarue, correct and complete to the bes~tc of my knowledge and belief . HOME C 7~, ) G i ~ ~ 3 ~ ~ 0 ~i~~GI/-'y2. ~ l~~ rn ~ W 0 R K c 't ~ ~ ~ 3 `~ ~ - ? 2 $ S ~k ly 23, '?~ ~l AXPAYER SIGNATURE TELEPHONE NUMBER DATE V r TOTAL CEnter on Line 5 of Tax computatlan~ s ;. E ~c~ 3, ,3 9 .~ .~ J ;~~ ,~ 4' , ~~ ~, ,;+ ~_ f M', ; ~ :MC vJ h ~ ~'~ a;,.:~, f ,; •~` ~,h . i ';~;~ M:: :,~.- ~A: ,~- ~";:s f- :~ ., i~»°' ;«' ~~ .~ . 3 , ~~~ .~" ~ . F_. ~~- ~'`~! V 7 V r l.. t Aa /`Y / ~ t t J~~ ~~ ~3 ~_ ~ ~ Q~ r, _~r ,~:t-~ 1 C ~~'..~~~.: = u.. . j f4 s i J~~ 4~ f * f~ ~~ * w~ ~J h ,; , QRPHP~N'S ~Ot~R~ ~~~~P,~=F~a ,~P.~~~ r~} PA, ^ ~.Y cJ ~ n ''~ ~ C j _ } ~ • ' t7" !J ~i' ~ '~ ~ ~ 4 ~ ~ Q~ ,,~ V, 1, ~ ~ ~ ~ (~ l,. ~~ ~~ l+~t':' ,~, . f ~w r ry ~~~ + r~ 1y ~~~ ~• YM n '( ~