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Home My WebLink About06-26-06 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 NEALON JANET M 11 MANOR DR MECHANICSBURG, PA 17055 n__n__ kid ESTATE INFORMATION: SSN: 161-03-8993 FILE NUMBER: 2106-0102 DECEDENT NAME: NEALON CAMILLE D DATE OF PAYMENT: 06/26/2006 POSTMARK DATE: 06/26/2006 COUNTY: CUMBERLAND DATE OF DEATH: 01/23/2006 NO. CD 006885 ACN ASSESSMENT CONTROL NUMBER AMOUNT 06115000 I $797.59 I I I I I I I I TOTAL AMOUNT PAID: $797.59 REMARI(S: CHECI(# 511717969 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEP~RTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 INFORMATION NOTICE " "'-'AND-,. TAXPAYER RESPONSE FILE ACN DATE NO. 21 06-0102 06115000 03-28-2006 REV-1543 EX AFP [09-00) EST. OF CAMI:iLcE D NEALON S.S. NO. 161-03-8993 DATE OF DEATH 01-23-2006 COUNTY CUMBERLAND TYPE OF ACCOUNT o SAVINGS o CHECKING 00 TRUST o CERTIF. JANET M NEALON 11 MANOR DR MECHANICSBURG PA 17055 REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 SOVEREIGN BANK 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 Pennsvlvania. QlIP5tior"ls may be answered by t:;:;!.I.::og [717) 787-83.27. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 1055176455 Date Established 09-05-1995 To insure proper credit to your account, two (2) 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 Tax Rate Potential Tax Due x 5,317.29 100.00 5,317.29 .15 797.59 TAXPAYER RESPONSE NOTE: If tax payments are made within three (3) months of the decedent's date of death, 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. x PART [!] [CHECK ] ONE BLOCK ONLY A. [] 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 nAn 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. x If you indicate a different tax rate, please state your relationship to decedent: PART ~ TAX RETURN - COMPUTATION LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due OF TAX ON JOINT/TRUST ACCOUNTS 1 2 3 4 5 6 7 8 x PART ~ DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID I $ TOTAL (Enter on Line 5 of Tax Computation) Under penalties of perjury, I declare that the facts I have reported above are true, correct and complete to the best of my knowledge and belief. HOME WORK ( ( ) ) T~I ~nun"'l~ ..IIIUDr::'r:I :h- i I ~ Ij 5" ~: jf << ~ g.~ II \ \'l~ :~ -': f ,~ ,t :tf g ~.: :.:: ~;~ \ ~ = ~.~ -, = t~, 'r. I -.. -v -- wffl :=;)><z ffii!o >....(i) w<_ IX:=;)2: U.cC 0->< ....2:<c ~ zc.... w~w~~ :Eu.(,)g:=;) ~o~ocn <:=;)t:~~ Q.< IX a....: IX WWWa:IX CIXx:W< ~~~Cx: ...J ~ ~ v :'\ Q <;t, C')' '0 t:: C o -,,1 <( ~ o cD 9 co N ~ """ ~ - - - - - - - - - - - - - - '--'