HomeMy WebLinkAbout09-25-08 (3)COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
INFORMA AND NOTICE
R- IZE~S P-. O N S E
TAXP:AYE
REV-1543 E% 11FP (09-09) ~ ~ ~ .~
FILE N0. 21 ~ ICI
ACN 08137388
DATE 08-22-2008
-z, ~e
` TYPE OF ACCOUNT
;~,~~ C~~~, E. ,bI,EL,~ CARR ®SAVINGS
S.S. ~~. ~34-34-3417 ^ CHECKING
D~~;t~~0~ DEATH 08-05-2008 ^ TRUST
r,-,~~~ 1 CUMBERLAND ^ CERTIF.
~r ~ 4 ~~ .
III"? ~ ~~ ~ REMIT PAYMENT AND FORMS T0:
TERRY SWARTZ ~ ~~,REGISTER OF WILLS
RD 1 BOX 1107 CUMBERLAND CO COURT HOUSE
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 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 C717) 787-8327.
COMPLETE PART 1 BELOW * * * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 75539-00 Date 09-30-1966 To insure proper credit to your account, two
Established <2) copies of this notice must accompany your
payment to the Register of Wills. Make check
Account Balance 873.74 payable to: "Register of Wills. Agent".
Percent Taxable X 50.000
NOTE: If tax payments are made within three
Amount Subject to Tax 436.87 (3) months of the decedent's date of death,
Tax Rate X .045 you may deduct a 5Y. discount of the tax due.
Any inheritance tax due will become delinquent
Potential Tax Due 19.66 nine C9) months after the date of death.
PART TAXPAYER RESPDNSE
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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 "A" and return this notice to the Register of
CHECK 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.
s ate our
If you indicate a different tax rate, please t y
PART €~~€, ;:::;:~ €:;:~ s::;<~ ;+;:;:;:=€:~ :: ~:::::::::~ ::;::-: ;:::;:::~ ::::::::::::::::::::::::: ~;;;:::;:::.:.:; ::~ ::t,::; ::::~ :::::;:,; ::;:;
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- UST ACCOUNTS
JOINT/TR
UTATI ON OF TAX ON
TAX RETURN COMP
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LINE 1. Date Establish _
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2. Account Balan
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3. Percent Taxabl
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o Tax 4
4. Amount Subject t
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eductions 5
5. Debts and D
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6
6. Amount Taxable
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7. Tax Rat
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8. Tax Due
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PART DEBTS AND DEDUCTIONS CLAIMED
0
DATE PAID PAYEE DESCRIPT ION AMOUNT PAID
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 C )
WORK C )
TAXPAYER SIGNATURE TELEPHONE NUMBER DATE
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
SWARTZ TERRY
100 SWARTZ LANE
BLAIR, PA 17006
-------- fold
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ESTATE INFORMATION: ssrv:
FILE NUMBER: 2108-0874
DECEDENT NAME: CARR HELEN
DATE OF PAYMENT: 09/25/2008
POSTMARK DATE: 09/25/2008
couNrY: CUMBERLAND
DATE OF DEATH: 08/05/2008
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
08137388 ~ $19.66
TOTAL AMOUNT PAID:
REMARKS:
INITIALS: JN
SEAL
$19.66
RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REV-1162 EXI11-961
NO. CD 010314
REGISTER OF WILLS