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Home My WebLink About01-0775 /?-/-/r COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE '*' BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z8D6Dl HARRISBURG, PA 171Z8-0601 NOTICE OF INHERITANCE TAX APPRAISEKENTL ALLOMANCE OR DISALLOMANCE OF DEDUCTION~I AND ASSESSKENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REV-1541 EX AFP (12-00> BRENDA HOLLINGSWORTH 205 CHESTER RD ENOLA PA 1~025 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 11-05-2001 HURST 05-19-2001 21 01-0775 CUMBERLAND 179-12-3155 01136410 Allaunt Rellitted LORRAINE C MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE1 PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ iEfv=is~i-E)f-AFit-(i1f:ooi------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 11-05-2001 ESTATE OF HURST LORRAINE C DATE OF DEATH 05-19-2001 COUNTY CUMBERLAND FILE NO. 21 01-0775 TAX RETURN WAS: S.S/D.C. NO. 179-12-3155 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 01136410 FINANCIAL INSTITUTION: PSECU ACCOUNT NO. 0179123155 TYPE OF ACCOUNT: (~SAVINGS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 05-31-1985 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due 11464.17 0.500 732.09 .00 732.09 .45 32.94 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT1 SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS1 AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 08-11-2001 CDOOO173 1.65 32.94 TOTAL TAX CREDIT 34.59 BALANCE OF TAX DUE 1.65CR INTEREST AND PEN. .00 TOTAL DUE 1.65CR . IF PAID AFTER THIS DATEI SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. · ( IF TOTAL DUE IS LESS THAN $11 NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT"" ( CRl1 YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. l COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 '* /b-/-/Y INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE ~/-OI- 77~ NO. 21 01136410 08-03-2001 REY-1545 EX AFP (09-00) EST. OF lORRAINE C HURST S.S. NO. 179-12-3155 DATE OF DEATH 05-19-2001 ,COUNTY CUMBERLAND TYPE OF ACCOUNT [i] SAVINGS o CHECKING o TRUST o CERTIF. BRENDA HOllINGSWOR~H 205 CHESTER RD ~. ENOlA PA 1702~ REMIT PAYMENT AND FORMS 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 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 calling (711) 187-8327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 0179123155 Date 05-31-1985 Established x 1,464.17 50.000 732.09 .045 32.94 TAXPAYER RESPONSE 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 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 SZ discount of the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. Tax PART [!]. A. [ CHECK ] ONE BLOCK B. ONLY c. [] 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. c=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. [] The above information is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART ~ below. PART ~ DATE PAID DEBTS AND DEDUCTIONS CLAIMED 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 TAX ON JOINT/TRUST ACCOUNTS OF 1 2 3 4 5 6 7 8 x x PAYEE DESCRIPTION AMOUNT PAID I $ I TOTAL (Enter on Line 5 of Tax Computation) perjury, I declare that the facts I ,y knowledge and belief. have reported HOME (7/ WORK (71 TELEPHONE and 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 'fAX OFFICIAL RECEIPT HOLLINGSWORTH BRENDA 205 CHESTER ROAD ENOLA, PA 17025 __n__n fold ESTATE INFORMATION: SSN: 179-12-3155 FILE NUMBER: 21-2001- 0775 DECEDENT NAME: HURST LORRAINE C DA TE OF PAYMENT: 08/20/2001 POSTMARK DATE: 08/11/2001 COUNTY: CUMBERLAND DATE OF DEATH: 05/19/2001 NO. CD 000173 ACN ASSESSMENT CONTROL NUMBER AMOUNT 01136410 I $32.94 I I I I I I I I TOTAL AMOUNT PAID: $32.94 REMARKS: BRENDA J HOLLINGSWORTH CHECK# 5826 SEAL INITIALS: SK RECEIVED BY: REGISTER OF WILLS MARY C. 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