HomeMy WebLinkAbout10-27-08 (3)CERTIFICATION Off' NOVICE UNDER Pa. O.C. Rule 5.~(a)
REGISTER OE ~ti'ILLS
Il/~ /V COUNTY. PENw'SYLVANIA
Narr,e of Deced
Date of Death: `~ -~ it /r VO
Date Letters Granted: ~Dl2
To the Register:
File Number:~G ~ " ~b ~ /~~~~Y ~ _
I certify that Notice of Estate Administration required by Pa. O.C. Rule ~.6(a) of the Orphans' Court
Rules was served on or mailed to the following beneficiaries of the above-captioned estate on
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Name:
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tl5iv~ r' ~e~r
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(If more space is needed, attach separate sheet.)
Notice has now been given to all persons entitled thereto under Pa. O.C. Rule 5.6(a) except:
'gnature ojPerson Filing [his .Fo
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~=- ~ ~ Capacity: JE.I Personal Representative ^ Counsel
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Form ,4W-08 rev. 10.13.06
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BUREAU OF INDIVIDUAL TAXES
PO BOX 280601
HARRISBURG PA 17128-0601
EST. OF CATHERINE L MILLER
SSN 184-38-0026
DATE OF DEATH 09-18-2008
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 1'7013
TYPE OF ACCOUNT
® SAVINGS
CHECKING
TRUST
CERTIF.
PENNSYLVANIA INHERITANCE= T
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE N0. 21 ~~--j~G~J
ACN 08148570
DATE 10-10-2008
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MEGAN A MI~t~~ER ~~~'~~'
5 EAST MARBLE STREET
MECHANICSBURG PA 17055
MEMBERS 1ST FCU provided the Department with the information below, whichi has been used in calculating the
potential tax due. Records indicate that at the death of the above-named decedent, you were a joiint owner/beneficiary of this account.
It you feel the 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 Taz laws of the Commonwealth of
Pennsylvania. Please call (717) 787-8327 with questions.
COMPLETE PART 1 BELOW ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 309413-00 Date 07-06-2007
To ensure proper credit to the account, two
Established copies of this notice must accompany
Account Balance $ 1,761.60 payment to the Register of Wills. Make check
payable to "Register of Wills, Agent".
Percent Taxable X 50.000
ARID Unt SUbjeCt to TaX $ 880 80 NOTE: If 1:ax payments are made within three
Tax Rate months of 1:he decedent's date of death,
X . 0 4 5 deduct a 5 percent discount on the tax due.
Potential Tax Due $ 39.64 Any Inheritance Tax due will become delinquent
nine monthsc after the date of death.
P~r TAXPAYER RESPONSE
1
FAILURE TO RESPOND WILL RESULT IN AN dFFICIAL TAX ASSESSMENT
A. ~ The above information and tax due is correct.
Remit payment to the Register of Wills with two copies of this notice to obtain
CHECK a discount or avoid interest, or check box "A" and return this notice to the Register of
0 N E Wills and an official assessment will be issued by the PA Department of Revenue.
B L 0 C K ~ B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inher'
0 N L Y to be filed by the estate representative. stance Tax return
C. ~ The above informs ion is incorrect and/or debts and deductions were paid.
Complete PART ~ and/or PART 3^ below.
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
PART if indicating a different tax rate, please state
relationship to decedent:
REV-1543 E% AFP (08.08)
OF TAX ON JOINT/TRUST ACCOUNTS
1
2
3 X
4
5
6 +~
7 X
8 $
PART
0
DATE PAID PAYEE
DESCRIPTION
AMOUNT PAID
TOTAL (Enter on Line 5 of Tax Computation) g
Under penalties of perjury, I declare that the facts I have reported above area true, correct and
complete to the best of my knowledge and belief.
HOME ( ) j
WORK ( )
TAXPAYER SIGNATURE TELEPHONE NUMBER
DATE
PAD
~ 1
2
3
4
5
6
7
8
DEBTS AND DEDUCTIONS CLAIMED
OFFICIAL USE ONLY ~ AAF
PA DEPARTMENT OF REVENUE