HomeMy WebLinkAbout12-08-08COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1 7 1 28-0601
RECEIVED FROM:
SHIPP ROBERT E JR
615 FORGE ROAD
CARLISLE, PA 17015
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ACN
ASSESSMENT
CONTROL
NUMBER
-------- fold
ESTATE INFORMATION: ssN:
FILE NUMBER: 2108-1226
DECEDENT NAME: SHIPP HAROLD
DATE OF PAYMENT: 12/08/2008
POSTMARK DATE: 1 2/05/2008
couNTY: CUMBERLAND
DATE OF DEATH: 10/07/2008
REV-1162 EX111-961
IVO. CD 010612
AMOUNT
08152544 ~ 5359.13
TOTAL AMOUNT PAID:
REMARKS:
SEAL
CHECK#1743
INITIALS: CJ
RECEIVED BY:
5359.13
GLENDA FA,RNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF INDIVIDUAL TAXES
PO BOX 280601
HARRISBURG PA 17128-0601 --
REV-1543 EX N?P,.tg4lel
PENNSYLVANIA INHERITANCE 1'AX
INFORMATION NOTICE 2Zi~'
AND FILE N0. 21 -O~"~
,~ ?"."~'.~~' ~TA)CPAYER RESPONSE ACN 08152544
-! '•~ - DATE 11-07-2008
200 D~'C -8 P 3~ 03
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ROBERT E SHIPP
615 FORGE ROAD
CARLISLE PA 17015
EST. OF HAROLD SHIPP
SSN
DATE OF DEATH 10-07-2008
COUNTY CUMBERLAND
REMIT PAYMENT AND FO RIMS T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
TYPE OF ACCOUNT
SAVINGS
® CHECKING
TRUST
CERTIF.
MEMBERS 1ST FCU provided the Department with the information below, which Ilas been used in calculating the
potential tax due. Recordls indicate that at the death of the above-named decedent, you were a .joint owner/beneficiary of this account.
If you feel the information is incorrect, Dlease 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. Please call. (717) 787-8327 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 209209-11 Date 09-08-2001
Established To ensure proper credit to the account, two
copies of this notice must accompany
payment to {:he Register of Wills. Make check
Account Balance $ 15, 961.30 payable to "Register of Wills, Agent".
Percent Taxable X 50.000
NOTE: If t;ax payments are made within three
Amount Subject to Tax $ 7, 980 • 65 months of tl~e decedent's date of death,
tax due
th
Tax Rate X . 0 4 5 .
e
deduct a 5 percent discount on
Anv Inheritance Tax due will become delinquent
Potential Tax Due $ 359.13 nine months after the date of death.
PART
FAILURE TO TAXPAYER RESPONSE
RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT
A.. ~ The
~~ above information and tax due is correct.
f this notice to obtain
•LLL 111 Remit payment to the Register of Wills with two copies o
dis count or avoid i nterest, or check box "A" and return this notice to the Register of
C H E C K a
Wills and an official assessment will be issued by the PA Department of Revenue.
C ONE
B L 0 C K
EI. ~ The
above
asset has been
or will be reported and tax
paid with the Pennsylvania Inheritance Tax return
0 N L Y to be fil ed by the estate representative.
C. ~ The above infor~ms ion is incorrect and/or debts and deductions were paid.
Complete PART I-i and/or PART ~ below.
PART If indicating a different tax rate, please state
relationship to decedent:
TAX RETURN - COMPUTATION
LINE 1. Date Established
2. Account Balalnce
3. Percent Taxarble
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 +fi
PAD
OFFICIAL U5E ONLY U AAF
PA DEPARTMENT DF REVENUE
1
2
3
4
5
6
7
8
PART DEBTS AND DEDUCTIONS CLAIMED
,,.rte nwrn PAVF[= DESCRIPTION AMOUNT PAID
Under penalties of perjury, I declare that the facts I have reported abov~7e ;are true, co/r,-rect and
complete to the best of my owledge and belief. HOME C ~~/ ) tY ''~77y7~~ ~ ~>
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TAXPAYER SIGNATURE TELEPHONE NUMBER DATE
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