HomeMy WebLinkAbout06-02-08
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 2Ei0601
HARRISBURG, PA 17128-0601
REV-1162 EX( 11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
COYLE JACQUELINE K
1212: MALLARD ROAD
CAMP HILL, PA 17011
u______ fold
ESTATE IINFORMATION:
FILE NUMBER: 2108-0459
DECEDENT NAME: LITTLE BETTE D
DATE OF PAYMENT: 06/02/2008
POSTMAFtK DATE: 05/30/2008
COUNTY: CUMBERLAND
DATE OF DEATH: 04/03/2008
NO. CD 009822
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
08124062 I $2,801.03
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS:
CHECK# 0236
SEAL
INITIALS: AJW
RECEIVED BY:
REGISTER OF WILLS
$2,801.03
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTI~ENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. ;?80601
HARRISIIURG, PA 17128- 0601
*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO. 21 ' .;-, (: is'\
08124062
05-27-2008
REV-15li3 EX AFP <09-00) I
TYPE OF ACCOUNT
EST. OF BETTE 0 LITHE [i] SAVINGS
S.S. NO. 0 CHECKING
DATE OF DEATH 04-03-2008 0 TRUST
~
COUNTY CUMBERLANDIi g 0 C~TIF.
REMIT PA_ AND F~S Tq;:,
~~~~~~E~NgF I . T ~USE'Q=., 'r~;
CARLISLE, PS 3 N ...I.. '-"
Zcn;:o:;;: c
g8~
9~
- ~
-:0 _
PSECU has provided the Department with the information listed below which hai>been used i~
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 Pennsyl.vania. Questions may be answered by calling 017> 787-8327.
COMPLETE PART 1 BELOW * * * SEE REVERSE SIDE FOR FILIN~ AND PAYMENT INSTRUCTIONS
lHf
JACQUELIN K COYLE
1213 MALLARD RD
CAMP HILL
PA 17011-1222
~
-
-
..
AcclJunt No. 0168142609-S7
Date
Established
04-13-2007
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
62,245.14
100.00
62,245.14
.045
2,801.03
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
[!J
A. ~The above information and tax due is correct.
LBl1. 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.
[CHECK ]
ONE
BLOCK
ONLY
8. r=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. r=J The above information is incorrect and/or debts and deductions were paid by you.
You must complete PART ~ and/or PART ~ below.
PART
~
TAX
If yoU indicate a different tax rate, please state your
relationship to decedent:
PART
[!J
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
RETIURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
LINE l. Date Established
2. Account Balance 2
3. P,e rcent Taxable 3
4. Amount SUbject to Tax 4
5. D,~bts and Deductions 5
6. Amount Taxable 6
7. TllX Rate 7
8. T,lx Due 8
x
x
PAYEE
DESCRIPTION
AMOUNT PAID
~
TOTAL (Enter on Line 5 of Tax Computation)
*
perjury, I declare that the facts
knowledge and belief.
have reported
"~
HOME (
WORK (
Correct and
\
foe
~.
...~
,.,
\,.
~.
\,))
Wi
\,))
\1,'\
~
~
",
\..:..,
\,.
t)
\"'..
~
~
~
~
%
~
~
~
~
~
~
t
-:..-
~
-;....-
-:..-
~
.
.
~
0:,...
.
-<I
\ ~
@
(';~t.
~ ,,-'f
.a~~
';t:>~
~~
'-<l~~
':.~
...:1- (')
~!i
-;' '"
....
. '"
I';,
.i.:~
?:'\
:.?
'):,
~,
~ t-!
'.il
;;..,
',1\
tj~
r'
~,
\~\
l
...,.,.
;.<'
4"
-.j
74'(
~;A
:4\
~~.
'"t't
)"
~.
""tJ
'}-