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Home My WebLink About09-06-12 (2)COMMONWEALTH OF PENNBVLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA t]128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT FOLSOM STEVEN J 6403 GLENWOOD ST MECHANICSBURG, PA 17050 REV-1162 EX111-96~ NO. CD 016478 ACN ASSESSMENT AMOUNT CONTROL NUMBER ------- ~o~a ESTATE INFORMATION: ssrt: 2oa-ze-oazt FILE NUMBER: 2112-0966 DECEDENT NAME: FOLSOM MARY E DATE OF PAYMENT: 09/06/2012 POSTMARK DATE: 09/05/2012 COUNTY: CUMBERLAND DATE OF DEATH: 04/29/2012 12130875 ~ 540.70 TOTAL AMOUNT PAID: REMARKS: SEAL CHECK#107 INITIALS: CJ RECEIVED BY: 540.70 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS ~ PENNSYLVANIA INHERITANCE: TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES PO Box zagsgl AND HARRISBURG PA 1]128-0601 f?F-{~( elamtnEBT"G p~ ~u~, ~ TAXPAYER RESPONSE +'"? ScP -6 Fit 12: 5~ STEVEN J ~'~"soMRIAND CO.. PA APT 3 6403 GLENWOOD ST MECHANICSBURG TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS FILE N0.21 ACN 12130875 DATE 05-10-2012 PA 17050-1900 EST. OF MARY E FOLSOM SSN 204-28-0421 DATE OF DEATH 04-29-2012 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 provi tletl the department with the information below, which was used in calculating the inheritance tax due. Records indicate that at the death of the aDOVe-nametl decedent, you were a joint owner/beneficiary of this account. If you 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 relati onshtp to the deceased 6y checking Box C in PART 1 below and writing "spouse" in PART 2. If you Del ieve the information is incorrect, Dl ease obtain written correction from the financial institution, attach a copy to this form and return it to the above address. Please call Ill OR7-8327 with questions. COMPLETE PART 1 BELOW ^ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS - Account No. 182561-11 Date 03-13-1999 To ensure proper credit to the account, two Established conies of this notice must acconpanv A<COUnt B818n<e 1 r8B8.77 payment to the Repi ster of Wills. Make check pay able to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE, If tax payments are matle wikhin three Amount Subject to TaX $ 904.39 nonths of the tlecedlnt•s data of death, Tax Rate X . 045 detluct a !i percent discount on the kax due. S 4 D . 7 D Anv inhe rift ante kax tlue will become delinquent Potential Ta% DUe nine nonths after the tlete of death. PART TAXPAYER RESPONSE 1^ A. The above information and tax tlue is correct. Renit pays ent to the Repi ster of Wills with two conies of this notice Yo obtain CHECK a tli scount or avoid interest, or return this notice 4o the Register of Wills antl ONE an official assessment will ba issuetl by khe PA Oepa rtnent of 12evenue. BLOC K B. ~ The above assek has been or will ba reporked and tax paid with the Pennsylvania inheritance tax return ONL Y filetl by the estate representative. C. ~ The above informs eon is incorrect and/or debts and tleductions went paid. Complete PART ~ and/or PART ~ below. PART If indicating a tlifferent tax rate, please state relationship t0 tlecedent: PART DEBTS ANO DEDUCTIONS CLAIMED ^3 LINE 1. Data Established 1 2. Account Balance 2 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 +S 5. Debts and Deductions 5 6. Amount Taxable 6 $ 7. Tax Rate 7 X 8. Tax Due 8 $ Under penalties of perjury. I declare that the facts I reported aDOVe are rue[' correct alyd~ ^Qco~m~plete t.o~~.,,/TT~t hne bes of my knowledge and belief. HOME C I ) U`)- aQJJ~IvI~/./Uy'QQ~ WORK ( > TAXPAYER SIGNATURE TELEPHONE NUMBER DAT DATE PAID PAYEE DESCRIPTION AMOUNT PAID w w 0 1j~~ ~~~f~~ '~,~4~~° r ~,. F e S:. ,~' +.. ..x, ~ ` F` {1~ ~ .~ ~.`~., ~~ x ~-~' / iF iP ^ t~ V '~ ~ r_ `~ ~.~ ~ c~'~' a ~ ...~..:'Cl... r'~tii;~~ r,= ;~iJl:~~~ ~1~^. s