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HomeMy WebLinkAbout03-27-06 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG I PA 17128-0601 .. INFORMATION NOTICE AND TAXPAYER RESPONSE FILE NO. 21 ACN 06113538 DATE 03-21-2006 REV-1543 EX AFP (09-00) '" i.. _'.' ... ".-..,..; EST. OF FRANK OHARA S.S. NO. 171-14-2873 DATE OF DEATH 12-30-2005 COUNTY CUMBERLAND TYPE OF ACCOUNT [i] SAVINGS D CHECKING o TRUST D CERTIF . MARY E MUNDORF 5256 MEADOWBROOK DR MECHANICSBURG PA 17055 REHIT PAYHENT AND FORHS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 PSECU has provided the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedentl you were a joint owner/beneficiary of this account. If you feel this information is incorrectl please obtain written correction from the financial institutionl attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth of Pennsylvania. Questions may be answerQd by calling (717) 787-8327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 0171142873 Date 10-05-1992 Established x 17,364.29 16.667 2.1894.11 .045 130.23 TAXPAYER RESPONSE To insure proper credit to your account I two (2) copies of this notice must accompany your payment to the Register of Wills. Make check payable to: "Register of Willsl Agent". Account Balance Percent Taxable Amount Subject to Tax Rate Potential Tax Due x NOTE: If tax payments are made within three (3) months of the decedent's date of deathl you may deduct a 5% discount of the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. Tax [CHECK ] ONE BLOCK ONLY A. rYI The above information and tax due is correct. ~ 1. You may choose to remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interestl or you may check box "An and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. B. [] The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent's representative. C. [] The above information is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART ~ below. PART ~ TAX RETURN - COMPUTATION OF TAX ON 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 Rate 7 X 8. Tax Due 8 JOINT/TRUST ACCOUNTS If you indicate a different tax rate, please state your relationship to decedent: PART [!] DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID I $ I TOTAL (Enter on Line 5 of Tax Computation) of perjury, I declare that the facts I have reported above are true, correct and of my knowledge and belief. HOME (1/1) 7& J --l3 ( t.f WORK (')1,) ,{,,{, -- ticD ..3 j;L'f / ot" TELEPHONE NUMBER DATE' COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. l80601 HARRISBURG, PA 171l8-0601 '* INFORMATION NOTICE AND TAXPAYER RESPONSE FILE NO. 21 ACN 06113536 DATE 03-21-2006 REY-1543 EX AFP (09-00) MARY E MUNDORF 5256 MEADOWBROOK DR MECHANICSBURG PA 17055 REMIT PAYMENT AND REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 TYPE OF ACCOUNT o SAVINGS [X] CHECKING o TRUST o CERTIF . FORMS TO: \ ' i ":'- ~,.-~ " : ::; 'j I EST. OF FRANK OHARA S.S. NO. 171-14-2873 DATE OF DEATH 12-30-2005 COUNTY CUMBERLAND PSECU has provided the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a COpy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth of Pennsylvania. Questions may be answered by ceIling (717) 787-8327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 0171142873 Date 10-05-1992 Established x 4,343.61 16.667 723.95 .045 32.58 TAXPAYER RESPONSE To insure proper credit to your account, two (l) copies of this notice must accompany your payment to the Register of Wills. Make check payable to: "Register of Wills, Agent". Account Balance Percent Taxable Amount Subject to Tax Rate Potential Tax Due x NOTE: If tax payments are made within three (3) months of the decedent's date of death, you may deduct a 5% discoun~ of the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. Tax [CHECK ] ONE BLOCK ONLY A. -R] The above information and tax due is correct. ~ 1. You may choose to remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or you may check box "A" and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. B. [J The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent's representative. C. [] The above information is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART ~ below. If you indicate a different tax rate, please state your relationship to decedent: PART ~ TAX LINE RETURN - COMPUTATION 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax S. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due OF TAX ON JOINT/TRUST ACCOUNTS 1 2 3 X 4 S 6 7 X 8 PART ~ DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID I TOTAL (Enter on Line S of Tax Computation) I $ of perjury, I declare that the facts I have reported above are true, correct and of IIY knowledge and beUef. HOME ('1 J 1 ) '7 f.,~-t. 31., if. WORK (11'7) J_l~_fL.~~<fo/) Jkt/OL T LEPHONE NUMBER DATE COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT MUNDORF MARY E 5256 MEADOWBROOK DR MECHANICSBURG, PA 17055 ___n___ fold ESTATE INFORMATION: SSN: 171-14-2873 FILE NUMBER: 2106-0264 DECEDENT NAME: OHARA FRANK DATE OF PAYMENT: 03/27/2006 POSTMARK DATE: 03/25/2006 COUNTY: CUMBERLAND DATE OF DEATH: 12/30/2005 NO. CD 006482 ACN ASSESSMENT CONTROL NUMBER AMOUNT 06113536 I $30.95 06113538 I $123.72 I I I I I I I TOTAL AMOUNT PAID: REMARKS: CHECK# 5796 SEAL INITIALS: MGO RECEIVED BY: REGISTER OF WILLS $154.67 GLENDA FARNER STRASBAUGH REGISTER OF WILLS ~l ~~I I ,..... _. I CL.- l- N L..., .... .......- " I"" ~ r-r ....1 .... I.., ,..:. (..1 l:) ~ -.... 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