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Home My WebLink About07-06-12~ PENNSYLVANIA INHERITANCE'. TAX INFORMATION NOTICE FILE NO. z1 I ~ ~-T BUREAU OF INDIVIDUAL TAXES PD BOX 280601 p r AND ACN 12135181 HARRISBURG PA lnza-gaol pe~ fI n.A- OFTAXPAYER RESPONSE DATE 06-07-2012 7011 JUL -6 PM 12120 p~~~p~p~cu e~~~~ S LOMUR? DAVID M WALL aUI+~RLAND CO.. PA 1416 OLO AIRPORT RD DOUGLASSVILLE PA 19518-8966 TYPE OF ACCOUNT EST. OF HELEN L WALL ^ savlNCs S$N 165-12-6684 ® CHECKING DATE OF DEATH 05-28-2012 ^ rkusr COUNTY CUMBERLAND ^ CERTIF. REMIT PAYMENT AND FDRMS TD: e_~ ~- REGISTER DF WILLS d~- ~~/// 1 COURTHOUSE Sgl1ARE ~I ~ (~Q. U-7~ CARLISLE PA 17013 -/ ~bn y 0 ~J1 ~~l~n'~t u~ MEMBERS 1sT FCU Drovitled the department wt th the information below, which was used in calculating the inheritance taz due. Records intli cafe that at the death of the above-named decedent. You were a Joint owner/beneficiary of this account. If you are the SpaUSe of Lhe 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 relati onshlp to the deceased by checking Box C in PART 1 below and wri ting "spouse" in PART 2. If you believe the informs ti On is incorrect. please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. Please call 717-787-8327 with puesii ons. COMPLETE PART 1 BELOW ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 132994'11 Date 05-29-1993 To ensure proper credit to the account, two Established copies of this notice Bust accoepanY _ payeent 4o the Register of Wills. Make check Account Balance S B ~ 103.15 payable to "R agister of Wills, Agent". Percent Taxable X 50.000 NDT E: If tax pavnents era Bade within three Amount Su Dj ect to Tax }~` 4, 051 .58 months of 'the decedent's data of death. R 045 deduct a 5 percent discount on the tax due. X Tax ate . AnY inheritance tax due will becone Jelin muent Potential Tax Due ,}` 182.32 nine Wont h:: after the date of death. PART TAXPAYER RESPONSE A. ^ The above inf oreat ion and tax due is correct. Resit oayn ent to the Ragi ster of Wills with two copies of this notice to obtain a viscount or avoid interest. or return this notice to the Register of Wills and CHECK r an official assessment will be issued by the PA Departmenk of R~avanue. I ONE L BLOCK B. ^ The above asset has been or will be r¢oo rted and tax paid with the Pennsvlvania inhe rikanca tax return ONLY filed by 4he estate rao resentative. L. ^ The above info rea ton is incorrect andf or debts and deductions were paid. L onplete PART 2~ and/or PART 3^ below. PART If indicating a different tax rate, please state 'S'i ~ I ~ y14V4 Iyi~: l S ~I syn',, ~ 1 relationship to decedenT: ,, , . `il I i~ ,GI y '`~i ~t~ ( ~ TAX RETURN - CALCULATION OF I TAX ON JOINT/TRUST ACCOUNTS ~I' t' LINE 1. Date Established 1 2. Account Balance 2 $ 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 +~ 5. Debts and Deductions 5 6. Amount Taxable 6 $ 7. Tax Rake 7 X e. Tax Due 8 $ PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penaltles of perjury, I declare that the facts I reported above are true, correct and w mpleta to the best of my knowledge and belief. HOME C ) WORK ( ) TAXPAYER SIGNATURE TELEPHONE NUNBER DATE ~ PENNSYLVANIA INHERITANCE: TAX INFORMATION NOTICE FILE No. 21 I~-~ BDR FAU OF INDIVIDUAL TAXES , PD BOX 280601 perm ~FF~E ~ AND ACN 12135180 HARRISBURG PA 17128-0601 bevaBTm AXPAYE R RE S PO NS E r r~~,,rW ~~,jl L+ DATE 06-07-2012 DAVID M WALL 1416 OLD AIRPORT DOUGLASSVILLE 2011 JUL -6 PM 1Z= 20 i~l..L'Pti. ~~..a ORPW~iN'S ~:OURt CO., PA RD PA 19518-8966 EST. OF HELEN L WALL SSN 165-12-6684 DATE OF DEATH 05-28-2012 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS 1 COURTHOUSE SQIJARE CARLISLE PA 1'7013 TYPE OF ACCOUNT ® SAVINGS CHECKING TRUST CERTIF. MEMBERS 1ST FCU provitled the tlepa rtment with the information below, which wds used in calculating the inheritance tax tlue. Records indicate that at the death of the above-named decedent, you were a ]pint owner/beneficiary of this account. If you are the Spouse of the deceased and any amount other Lhan zero is reflected below on the Potential Tax Due line, note no tax may be tlue, but you must notify the de artment of your relationship to the deceased by checking Box C in PART 1 below antl wrtti ng "spouse" in PART 2, If you believe the information is incorrect. please obtain written correction from the financial institution, attach a copy to this form and return. it to tfie above atltlresz. Please call 7ll-7B7 -832] with puesti ons. COMPLETE PART 1 BELOW ^ SEE REVERSE SIDE FOR FILING AND PAYMENT INS 1'R UCTIUNS Account No. 132994-00 Date 05-29-1993 To ensure proper credit to the account, two Established copies of this notice oust accoepany paYwent to the Regl star of Wills. Make check AccOUnt Balance $ 5,008.61 payable to "Register of Wills. Agent". Percent Taxable X 50.000 NDTE~ If kax paYmenks are wade within three amount Subject to Tax $ 2,504.31 wonths of the decedent's data of death, Tax Rate )( .045 deduct a 5 percent discount on the tax due. Any inhari'kanee tax due will becowe delinquent Potential TaX DUB $ 112.69 nine wonths after the data of tleath. PART TAXPAYER RESPONSE 0 A. ~ The above info rwation and tax tlue is correct. Rewii paYwant to the Regi star of Wills with 4wa copies of this notice to obtain r C HECK a tli scount or avoftl interest, or return this notice to the Register of Wills and I ONE ~ an official assesswent will be issued by the PA Departwenk of Revenue. L BLOCK B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania inheritance tax return ONLY filed by the estate representative. C. ~ The above inf orwa Ton is incorrect andf or debts antl deductions were paitl. CoeplBte PART 2~ and/or PART ~ be}ow. PART If Sndlcating a different tax rate. Please state ~,~}~Yi~Y ~S ~i~l ~, I, °~1~~ ~!II~ ~~ ii~~)lyfl, ,; f relationship to decetlent: i'I ~ ~i ~, TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS ~I LINE 1. Date Established 1 2. Account Balance 2 $ 3. Pe roeni 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 e $ Under penalties of perjury, I declare that the facYS I reporfetl above are true, correct and complete to The best of my knowledge antl belief. HOME I WORK ( ) TAXPAYER SIGNATURE TELEPHDNE NUMBER PART uen1J wnu LCYVLIlYnJ s.~wamcv DATE PAID PAYEE DESCRIPTION AMOUNT PAID i 1 l ~ ~ __ ~. ~: ,mot o ~,'~ ,~ ~~: s ~` C' C.p . ~~ ~+~ .. 3a~, H r. y, m~~ N ~ V }t. b F!F_COnCEG f?FF-CE OF AEG~~ ~ EA `r tN4klS 2~I1 JUL -6 PM 12~ 2~ vl1L,~li . '. ORPHAN'S COURT CIJMBEIiU~ ~.. R4 `~ ,~ ~ ~ `~ ~~ ~~~ ~~ ~~ try ~M 4~ r•~• .., _. __ v~ - ~ _.__ _ __ ~_ E r,E'~~ 'mac ~c-e~ 2~ ~~ _ r Y r ~ ? ~ ~ n, ~ i C~ ~J s J t ~ , ' 1 .~~+~-~' ! L {~~+ ~~ G,C-~ C~ ('~_ f l T /l .. ~ 'C~y~,.J __:~ ' i ~~- i _ ,- ~. ~ i ~ i T t .., z ~~-- ._ ~ / ;; ~ " ;Tx y.~ ..Q e~~ .. ..~~.¢.c. ,~- ®1983 FraAdn Quart Ca. PMpetlM USA Yelbx CL 0061 Green CL 0082 PeY[C160&i 6Wa CL 0066 lAx CL 416] Ran6aw CL 6106 ®1883 FrenIJin West Co. Rinfetlin USA YeAVx CL W81 amen CL 4082 pnk CL4p63 &ue CL 1086 L3ec CL4/8] FeiLptvGt 9146