HomeMy WebLinkAbout09-25-08COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE NFORMATION NOTICE FILE N0. 21 Q~ ~-~~
I
BUREAU OF INDIVIDUAL TAXES _.-. _
DEPT. 280601 ACN 08137390
HARRISBURG, PA v12B-ocol T-AX PAY ER R E S P O N S E
DATE 08-22-2008
NEY-1543 EX FFP (09-00) ~ - - "' ~-
TYPE OF ACCOUNT
~~~~ ~~~ ~~ E~~ ~a0p HELEN CARR ® SAVINGS
S.S. N0. ^ CHECKING
~~ ~`°'~`: ~iA}TE OF DEATH 08-05-2008 ^ TRUST
~~'~'-~ ``',
, `GCIU~'Y CUMBERLAND ^ CERTIF.
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~
~~~'~~
REMIT PAYMENT AND FORMS T0:
TERRY SWARTZ REGISTER OF WILLS
RD 1 SOX 1107 CUMBERLAND CO COURT H OUSE
BLAIN PA 17006 CARLISLE, PA 17013
MEMBERS 1ST FCU 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 .)Dint 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 (717) 787-8327.
COMPLETE PART 1 BELOW * * * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 75539-05
Account Balance
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".
Percent Taxable X 50.000
NOTE: If tax payments are made within three
Amount Subject to TaX 351 .21 I3) months of the decedent's date of death,
Tax Rate X . 045 you may deduct a 5% discount of the tax due.
Any inheritance tax due will become delinquent
Potential Tax Due 15 • 80 nine (9) months after the date of death.
PART TAXPAYER RESPONSE
' : ~:..::: ~:~:: ~ ..:111 i:~.~..:~E.ES.~ Lfi':IHAIi D E E ID IAE. 't`AIE.. ,A~~ E~S:ET:::HA~ ~~#i ~.I~I.::: T:N I S N D TI ~ E is
...1~]k I1.1111i E...'fl1l.....~EE E~?'~fl~I~ ................................................
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
C H E C K 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 ONE
B L 0 C K B. ^ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
0 N L Y 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 If you indicate a different tax rate, please state your
relationship to decedent:
TAX RETURN - CDMPUTATION
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 X
4
5
6
7 X
8
PART DEBTS AND DEDUCTIONS CLAIMED
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
Date 03-12-1997
Established
702.42
WORK ( ~
TAXPAYER SIGNATURE TELEPHONE NUMBER DATE
TOTAL (Enter on Line 5 of Tax Computation) 5
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. unMF f 1
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1 7 1 28-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
SWARTZ TERRY
100 SWARTZ LANE
BLAIR, PA 17006
fold
ESTATE INFORMATION: ssN:
FILE NUMBER: 2108-0874
DECEDENT NAME: CARR HELEN
DATE OF PAYMENT: 09/25/2008
POSTMARK DATE: 09/25/2008
COUNTY: CUMBERLAND
DATE OF DEATH: 08/05/2008
NO. CD 010316
REV-1162 EXI11-96}
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
08137390 ~ 515.80
TOTAL AMOUNT PAID: 515.80
REMARKS:
INITIALS: JN
SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS