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Home My WebLink About07-31-12COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NESBIT JOHN F 508 E KELLER ST MECHANICSBURG, PA 17055 REV-1162 EX111-96) NO. CD 016330 ACN ASSESSMENT AMOUNT CONTROL NUMBER -------- fold ESTATE INFORMATION: FILE NUMBER: 2112-0828 DECEDENT NAME: NESBIT DORIS J DATE OF PAYMENT: 07/31 /201 2 POSTMARK DATE: 07/30/2012 couNTY: CUMBERLAND DATE OF DEATH: 06/15/2012 REMARKS: SEAL CHECK#113 12138282 ~ 5136.12 12138283 ~ $49.07 12138284 ~ 524.99 12138285 ~ 5115.15 TOTAL AMOUNT PAID: INITIALS: HMW RECEIVED BY: 5325.33 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES PD BDX 280601 penn~~~ HARRISBURG PA 17128-0601 __. ~_i REV-1543 PENNSYLVANIA INHERITANCE TAX ~( ~/ INFORMATION NOTICE FILE N0. 21'-~~-~L'/~C #~ ;,,~:.v,tJ~ ((~~ AND ACN 12138282 ~;£-- ~, I`c'I'AXPAYER RESPONSE DATE 06-28-2012 t}a ' ' ~, j JOHN F NESBIT CIlP~E3ERt-~,~~ ~'~" PA 508 E KELLER ST MECHANICSBURG PA 17055-6528 EST. OF DORIS J NESBIT DATE OF DEATH 06-15-2012 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 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 y0U art 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 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. Please call 717-787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 22196-00 Date 07-03-1979 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance $ 6,049.72 payment to the Register of Wills. Make check payable to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax payments are made within three Amount Subject to Tax $ 3, 024.86 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 $ 136.12 nine months after the date of death. PART TAXPAYER RESPONSE FAILURE TO RESPOND WILL RESULT IN AN 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 return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. C ONE 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 information 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 RE TURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS PAD LINE 1. Date Established I 1 2. Account Balance 2 $ 2 3. Percent Taxable 3 X 3 4. Amount Subject to Tax 4 $ 4 5. Debts and Deductions 5 S 6. Amount Taxable 6 $ 6 7. Tax Rate 7 X 7 8. Tax Due 8 $ 8 PART ^3 DEBTS AND DEDUCTIONS CLAIMED TOTAL (Enter on Line 5 of Tax Computation) S ,\ Under penalties of perjury, I declare that the facts I complete to tltie 4.est of my }4no~;.edge and belief. reported above are true, correct and ~~V HOME (7~7 ) ~~et ~~j~E~ V WORK ( ) ~' ~Cj/„Z, TELEPHONE NUMBER DATE DATE PAID PAYEE DESCRIPTION AMOUNT PAID ~ PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE FILE N0. 21'- ~'[1~~!! BUREAU OF INDIVIDUAL TAXES PD Box 2BO6o1 A N D r' P~~~~~V ~ ACN 121 8283 HARRISBURG PA 17126-0601 fi~~~okrbav~~i~zo~.we`de TAXPAYER RESPONSE _r~v. ~3.~AFP.tok,- ~~ DATE 06-28-2012 k'-, '. -~~~ ~~ =j~2 JtIL 3 ( P~412~ 38 (, ~~ .. J O H N F N~S)B ~~RI,..~~lD CO" ~A 508 E KELLER ST MECHANICSBURG PA 17055-6528 EST. OF DORIS J NESBIT DATE OF DEATH 06-15-2012 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 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 y0U 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 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. Please call 717-787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 22196-11 Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due Date 10-26-1982 Established $ 2,180.86 X 50.000 $ 1,090.43 X .045 $ 49.07 To ensure proper credit to the account, two copies of this notice must accompany payment to the Register of Wills. Make check payable to "Register of Wills, Agent". 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 of death. PART TAXPAYER RESPONSE FAILURE TO RESPOND WILL RESULT IN AN 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 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 filed by the estate representative. C. ~ The above information is incorrect and/or debts and deductions were paid. Complete PART 2~ 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 - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS PAD LINE 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 Deductions 5 5 6. Amount Taxable 6 '~ 6 7. Tax Rate 7 X 7 8. Tax Due 8 $ $ /~ PART DEBTS AND DEDUCTIONS CLAIMED ^S DATE PAID PAYEE DESCRIPTION AMOUNT PAID ~ PENNSYLVANIA INHERITANCE TAX BUREAU OF INDIVIDUAL TAXES I N F O R M A T I O N N O T I C E F I L E N 0. 2 1 d~~ Po Box zaosBl p ~,~/~~~ ,t. ~ AND HARRISBURG PA 17128-0601 ~U~ ~J~ ACN 12138284 o „_ r~~a 'oEi~verhr, TAXPAYER RESPONSE ~;~~ 7 C DATE 06-28-2012 REV~~4$„~%.~1{~ (p5 11a~ .'..,-L ~~ s~': ~ .~~it 31 P~ I2; 39 ((`` OCE3E~"L~u~i~ ~C4,~TPA JOHN F NESBIT'~1M 508 E KELLER ST MECHANICSBURG PA 17055-6528 EST. OF DORIS J NESBIT DATE OF DEATH 06-15-2012 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 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 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. Please call 717-787-8327 with questions. COMPLETE PART I BELOW ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 14039-00 Date 12-21-1972 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance $ 1 , 110.63 payable to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax payments are made within three Amount Subject to Tax $ 555.32 months of the decedent's date of death, TaX Rate )( . 045 deduct a 5 percent discount on the tax due. Any inheritance tax due will become delinquent Potential Tax Due $ 24.99 nine months after the date of death. PART TAXPAYER RESPONSE FAILURE TO RESPOND WILL RESULT IN AN 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 return this notice to the Register of Wills and 0 N E an official assessment will be issued by the PA Department of Revenue. 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 filed by the estate representative. C. ~ The above informs ion is incorrect and/or debts and deductions were paid. Complete PART ~2 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 - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS PAD LINE 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 Deductions 5 5 6. Amount Taxable 6 'fi 6 7. Tax Rate 7 X 7 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 ~ complete to t~ e~st of my knowledge and belief. HOME C 7 ~~ // ) ~~~'~~~lye \`\1 \1 WORK ( ) 7 3o-,~at(~ TAXPA R SIGNATURE TELEPHONE NUMBER DATE TOTAL CEnter on Line 5 of Tax Computation) S BUREAU OF INDIVIDUAL TAXES PO BOX 280601 HARRISBURG PA 17128-0601 penr~~r,~~ita DEPART T.L7~~AE~VEfiIIE' REV-1543~jF-(~FP (06~31J~ PENNSYLVANIA INHERITANCE TAX fj /~f~ ~( INFORMATION NOTICE FILE NO. 21'"~~'J"`~~"~~" ,,;^~~`~~ ~~ AND ACN 12138285 TAXPAYER RESPONSE t,~~l ~ C DATE 06-28-2012 ;! .L.J i? .iUL 3 I P~f i2~ 35 QI~;F'~r''jf~y'~ uJ~11T CUMf3ERl.AN~ CO., PA JOHN F NESBIT 508 E KELLER ST MECHANICSBURG PA 17055-6528 DATE OF DEATH 06-15-2012 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 F CU 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 y0U 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 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. Please call 717-787-8327 with questions. COMPLETE PART I BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 14039-40 Date 06-20-2008 7o ensure proper credit to the account, two Established copies of this notice must accompany payment to the Register of Wills. Make check Account Balance 5 117.83 ~ payable to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax payments are made within three Amount Subject to Tax ~` 2 558.92 ~ 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 $ 115.15 nine months after the date of death. PART TAXPAYER RESPONSE FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT A. {~ The above information and tax due is correct. t~ 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 0 N E an official assessment will be issued by the PA Department of Revenue. 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 filed by the estate representative. C. ~ The above information is incorrect and/or debts and deductions were paid. Complete PART ~2 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 - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS PAD LINE 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 Deductions 5 S 6. Amount Taxable 6 $ 6 7. Tax Rate 7 X 7 8. Tax Due 8 $ $ PART DEBTS AND DEDUCTIONS CLAIMED 0 DATE PAID PAYEE DESCRIPTION AMOUNT PAID TOTAL CEnter on Line 5 of Tax Computation) S Under penalties of perjury, I declare that the facts I reported above are true, cor/rec(~t^ an/d complete to es of~y owledge and belief. HOME C 7~~ ) ~~ty-'rJ ~~P~ TAXPA; R SIGNATURE TELEPHONE NUMBER DATE -~r Springy Cree~ Rehabilitation & Health Care Center Sins e~S z S ~ na~ r~ ~ ~~ ovn~ c~e~ 3 ~~5~ v 1_ ~ n ~ ~ ~ 1205 South 28'h Street Harrisburg, Pennsylvania 17111 717.565.7000 • 717.558.8136 Fax www.springcreekcare.com '~' W ~~ :~ d r > ~ w ~ ~:. ~ ,. O ~\ r^~ :t a i~ k' i _ . 1~ (r 1 ~ `1. t "~ ~ C.i ~ „. y ._. _ ~ '. '. . ) !._ r _~ ,~_ _..., _ r Y'' Ci'. '.~_ +~ ~'D ! ~ ~ p ~ V