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Home My WebLink About08-08-11COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX111-961 NO. CD 014818 KLEIN DOROTHY E 5435 BONNYRIGG COURT MECHANICSBURG, PA 17050 fold ESTATE INFORMATION: SsN: 180-26-5692 FILE NUMBER: 21 1 1 -0859 DECEDENT NAME: CORKLE ELLEN L DATE OF PAYMENT: 08/08/201 1 POSTMARK DATE: 08/05/201 1 couNTY: CUMBERLAND DATE OF DEATH: 06/27/201 1 REMARKS: CHECK# 2862 ACN ASSESSMENT AMOUNT CONTROL NUMBER 11150019 ~ 52.85 TOTAL AMOUNT PAID: INITIALS: CJ 52.85 SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS -~ PENNSYLVANIA INHERITANCE TAX BUREAU OF INDIVIDUAL TAXES ~ INFORMATION NOTICE Po Box 2so6o1 ~ ''" FILE N0. 21 ,'I G~"~`i HARRISBURG PA 17128-0601 pe 1~8T11a ~t7~. ~" AND ACN 11150019 DEPA~~~REVEN U~ 5„ ~~ ~. TAXPAYER RESPONSE REV-1~,~, ~XI.AfP- (85-117', I-~ '' -'-`' DATE 07-27-2011 OR~~-1,~~1 ~ CQIRT Cll~~~~" ~ ~ r'~~~ PA DOROTHY E KLEIN 5435 BONNYRIGG CT MECHANICSBURG PA 17050 EST. OF ELLEN L CORKLE SSN 180-26-5692 DATE OF DEATH 06-27-2011 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 FCU 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 If youybelhevdepnertmformatfonoUr,neoaectDplease obtaendeCe~eedorYecthonkfrom Bhe CnanlciaARTnstibe~oow aadttachiainopy toOthie'forlm aAdTreturn it to the abovettaddress. Please call 717-787-8327 with Questions. COMPLETE PART 1 BELOW ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 1 08460-00 Date 05-09-1989 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance $ 400.23 Payment to the Register of Wills. Make check payable to "Register of Wills, Agent". Percent Taxable X 16.667 Amount Subject to Tax Tax Rate Potential Tax Due RI CHECK ONE BLOCK ONLY $ 66.71 X .045 NOTE: If tax payments are made within three months of the decedent's date of death, deduct a 5 percent discount on the tax due. Any inheritance tax due will become delinquent nine months after the date ~f ~o~+~ A. ~ The above information and tax due is correct. TAXPAYER RESPONSE AILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT Remit payment to the Register of Wills with two copies of this notice to obtain 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. 6. ~ The above asset has been or will be reported and tax paid with the Pennsylvania inheritance tax return filed by the estate representative. C. ~ The above information is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART 3LJ below. PART If indicating a different tax rate, please state relationship to decedent: OFFICIAL USE ONLY ~ AAF TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS PAD LINE 1. Date Established 1 I 2. Account Balance 2 $ 2 3. Percent Taxable 3 X 3 4. Amount Subject to Tax 4 $ 4 5. Debts and Deductions 5 - 5 6. Amount Taxable 6 $ 6 7. Tax Rate 7 X 7 8. Tax Due g $ 8 PART ^3 DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTrnN PA DEPARTMENT OF REVENUE U, r penalties of perjury, I declare that the facts I reported above are true, correct and om lete to the st of m knowledge and belief. HOME ( } _ = WORK C } TAXPAYER GNATURE TELEPHONE NUMBER ATE