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Home My WebLink About09-06-12COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OP REVENUE BUREAU OF INDIVIDUAL TA%ES DEPT. 280601 HAgRISBURG, PA 1 J128-0601 RECEIVED FROM: FOLSOM STEVEN J 6403 GLENWOOD ST APT 3 MECHANICSBURG, PA 17050 ------- IuIJ ESTATE INFORMATION FILE NUMBER: DECEDENT NAME: DATE OF PAYMENT: POSTMARK DATE: COUNTY: DATE OF DEATH: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT N0. CD 016477 SSN: 2112-0966 FOLSOM MARY E 09/06/2012 09/05/2012 CUMBERLAND 04/29/2012 REMARKS: CHECK#108 SEAL ACN ASSESSMENT AMOUNT CONTROL NUMBER REV-1182 EXI11-9fi1 59.62 TOTAL AMOUNT PAID: INITIALS: HEA RECEIVED BY: REGISTER OF WILLS GLENDA EARNER STRASBAUGH REGISTER OF WILLS ~ PENNSYLVANIA INHERITANCE TAX BUREAU OF INDIVIDUAL Taxes pp(~- `":~,~ _ ` INFORMATION NOTICE FILE N0. 21 PO BOX 280601 B~E'IR'~ ~F~Y~B~ FI(/ [ AND HARRISBURG PA 17128-0601 OEPAq ~'d Ft)uE'~' ~ 01 ACN 12130874 '~" ., ~' ;"%~~ ~ p TAXPAYER RESPONSE eEe-rs«ex ,fP }o:.uY' '-w DATE 05-10-2012 1`h'Z SEP -6. p~q ~; ~ q TYPE OF ACCOUNT G EST. OF MARY E FOLSOM ® spvl NGs ' ~ CHECKING ~+1~flPf'1AiV`J ~~~~~ DATE OF DEATH 04-29-2012 ~ TRUST VIIMBER'AA' COUNTY CUMBERLAND ~ CERTIF. ~: IIV~ C~., PqREMIT PAYMENT AND FORMS TD: STEVEN J FOLSOM REGISTER OF WILLS APT 3 1 COURTHOUSE SpUARE 6403 GLENWOOD ST ~ CARLISLE PA 17013 MECHANICSBURG PA 17050-1900 MEMBERS 1ST FCU provided the tlepa rtment with the information below, which was used in calculating the inheri tanre tax due. Records indicate that at the death of the above-named tlecetlen t, you were a joint owner/beneficiary of this account. IP y0U are the SpODSe Of Lhe deceased and any amount other than zero is refiected below on the Potential Tax Due line, note no tax may be due, but you must notify the de artment 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 puesti ons. COMPLETE PART 1 BELOW of SEE REVERSE SIDE FOR FILIN6 AND PAYMEiN7 INSTRUCTIONS Account No. 18256 1-0 0 Date 03-13-1999 To ensure proper credit to the account, two Esteblished copies of '[his notice must accompanv Account Balance ~• ~ 425 (>2 oavment to The Register of Wills. Make check X payable to •'Reei ster of Wills, Agent". Percent Taxable 50.000 Amount SubSect So Tax S 212 81 NOTE: If i;az payments are Wade within three TdX Rata monkhs of 1:he decedent's date of death, X . 0 45 deduct a 5 percent discount on the tax due. Potential Tax Dua S 9 58 Anv inhe ri l:anca tax due will becone delinaaent nine nonths~ after the date of death. PART TAXPAYER RESPONSE 1^ A. The above information and tax due is correct. Ranit payment fo the Register of Wills with two copies of This rioti ce to obtain CHECK ~ a discount or avoid intares4, or return this notice to the Register of Wills and ONE an official arse ssmenk will be issued by the PA Depa rtwent of Revenue. BLOCK B. The above asset has been or will ba reported and tax ONL Y paid with the Pennsylvania inheritance tax return filed by the estate representative. C. ~ The above info r~~mya, ¢on is incorrect and/or debts and deductions were paid. Conplete PART u and/or PART 3rl below. PART If indicating a different tax rate, please st O relationship to decadent: TAX RETURN - CALCULATION LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject Yo lax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate e. Tax Due PART 0 DATE PAID PAYEE Under Denal tfes of perjury c o~pleta to fha best _of my OF TAX ON JOINT/TRUST ACCOUNTS 1 2 S s X A S 6 ~ 7 X e S DEBTS AND DEDUCTIDNS CLAIMED DESCRIPTION (Enter on Line 5 of Tax Computation AMOUNT PAID I declare that the facts I reported above are tru~,~o reek and nowle and belief. HOME ( Pl `7 l b,~~ 1 WORK ( • ) r TELEPHONE NUMB R DATE ~~ ~ 2 SEP -6 PM ~' ~ 2 pkPHAN'S ;OU~i? CUMBERLPND CO.. PA I~ r_~ ~. (ail u}' u) ~ - ~~ ~ S v/ O _ W i sg R' ~ T yy O c~RbN n8~3 ~N ~a ,~. ~. r'~ 3~..Y.~1 `;~. ~Si ~ a, ~~ ~; i~ IW :ak. ~.