HomeMy WebLinkAbout04-15-08 (2)COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT.280604'~-"
HARRISBURG, PA 1 7 1 28-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
THOMAS ANDREW L
905 GREENBRIAR DRIVE
MECHANICSBURG, PA 17050
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ESTATE INFORMATION: ssN: 200-34-9292
FILE NUMBER: 2108-0428
DECEDENT NAME: THOMAS GEORGE B
DATE OF PAYMENT: 04/ 1 5/2008
POSTMARK DATE: 04/ 1 4/2008
COUNTY: CUMBERLAND
DATE OF DEATH: 01 / 1 8/ 2008
REV-1162 EX111-96)
NO. CD 009561
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
08114332 ~ 548.70
TOTAL AMOUNT PAID:
REMARKS: ANDREW L THOMAS
CHECK# 806
SEAL
INITIALS: WZ
548.70
RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE I N F O R M AT I O N N O T I C E
FILE N0
21
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BUREAU DF INDIVIDUAL TAXES AND .
DEPT. 280601
TAX P AY E R R E S P O N S E ACN 081 14332
HARRISBURG, PA 1712E-g6ol
eEV-1545 E% AFP (09-00) DATE 04- 09-2008
ANDREW L THOMAS
905 GREENBRIAR DR
MECHANICSBURG PA 17050-1916
TYPE OF ACCOUNT
EST. OF GEORGE B THOMAS ^ SAVINGS
S.S. N0. 200-34-9292 ® CHECKING
DATE OF DEATH 01-18-2008 ^ TRUSr
COUNTY CUMBERLAND ^ CERTIF.
REMIT PAYMENT AND FORMS T0:
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 answored by calling (71?? 7E7-8327.
COMPLETE PART 1 BELOW * * * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 0188627586 Date 04-08-1983 To insure proper credit to your account, two
Established C2) copies of this notice must accompany your
payment to the Register of Wills. Make check
Account Balance 2, 278.50 payable to: "Register of Wills, Agent".
Percent Taxable X 50.000
NOTE: If tax payments are made within three
Amount Subject to Tax 1,139.25 (3) months of the decedent's date of death,
Tax Rate X .045 You may deduct a 5i discount of the tax due.
Any inheritance tax due will become delinquent
Potential Tax Due ~{g,~0 .9~ ~c 51 .27
nine l9) months after ,the date of ~ h.
PART TAXPAYER RESPONSE =A ~'
=:
n
...:
: ; ,
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.,.17€~E."~'E:EI.E,.'E".....'lil. ~:::::::::::::::::::::::::::~ ::::::::::::::::::::::::::::::::::::::::::::::::
...1411.....A.L":C:'F.#'.5:'F.'isE~>:~>T3k~K:~ :::::::::::::::::::::::::::::-,.,::.:,.,.,.:.:.,.:.:.,.:.:.,.,.:.:.,.:.,.,.:.....:. .::.,.,.,.,.,.:.,., ..:.,. ..........
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A. The above information and tax due is correct. ~~~- -- L-.: - ~
1. You may choose to remit vayment to the Register of Wills with two copies of tp1~~,'ioticcL£b obtaSN ;-`7
C H E C K a discount or avoid interest, or you may check box "A" and return this nati.c~-t~-$he Register ef~;`•.3
C 0 N E ~ Wills and an official assessment will be issued by the PA Department of Revepu~.~~ ~. ~- ;-~
_ ~ 1,T
B L 0 C K B. ^ The above asset has been or will be reported and tax paid with the Pennsylvania ~eritancP„--t. ax retufrf
ONLY to be filed by the decedent's representative. 'C7 ~~ '-` `~
C. ^ The above information is incorrect and/or debts and deductions were paid by you. .~
You must complete PART 2^ and/or PART 3^ below.
If ou indicate a different tax rate lease state our
PART Y , P Y
:::::::::::::::::::::::::::::::::
r e l a t i o n s h i t o d e c e d e n t: .............:...:...:....................:. ..............:::............-..,.......::...-.:::.....
2
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TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
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LINE 1. Dote Es.ablahed 1 r .... .. - ,.:::
2. Account Balance 2
3. Percent Taxable 3 X
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4. Amount Subject to Tax 4
J
5. Debts and Deductions 5
6. Amount Taxable 6
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7 . T a x R a t e 7 X € ~ ~ ~ ~i==i':':s? ::::::::::::: ::::::::: ::::::::::::::::::::::::: ~ ;:::;:::; ~:; ~:; ~~ :; _~ ~:;:;::; ~:;:; :;:;:;:;:;:;:;:; :;:;:;:;:;:;:;:;:
8. Tax Due 8
.........................
PART DEBTS AND DEDUCTIONS CLAIMED
^H
DATE PAID PAYEE
DESCRIPTION
AMOUNT PAID
TOTAL IEnter on Line 5 of Tax Computation) $
Under penalties of perjury, I declare that the facts I have reported above are true, correct and