HomeMy WebLinkAbout12-15-08COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 57128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
THOMAS LINDA M
8 BOURBON RED DRIVE
MECHANICSBURG, PA 17050
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ESTATE INFORMATION: ssN: i s3-~ 2-50~ 2
FILE NUMBER: 2108- 1 251
DECEDENT NAME: TITUS WAYNE H
DATE OF PAYMENT: 12/15/2008
POSTMARK DATE: 12/12/2008
couNTY: CUMBERLAND
DATE OF DEATH: 06/ 1 4/2008
REV-1162 EX111-96)
NO. CD 010646
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
08160921 ~ 56.14
TOTAL AMOUNT PAID:
REMARKS:
CHECK# 393
SEAL
INITIALS: AJW
56.14
RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE _
BUREAU OF INDIVIDUAL TAXES AND FILE N0. 21 ~~~ `1.~`
Po sox zas6ol TAXPAYER RESPONSE ACN 08160921
HARRISBURG PA 17128-0601 DATE 12-11-2008
REV-3543 E% AFP (OB-OB)
EST. OF WAYNE H TITUS
SSN 163-12-5012
DATE OF DEATH 06-14-2008
CDIINTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
LINDA M THOMAS REGISTER OF WILLS
8 BOURBON RED DR CUMBERLAND CO COURT HOUSE
MECHANICSBURG PA 17050-7902 CARLISLE, PA 17013
TYPE OF ACCOUNT
SAVINGS
® CHECKING
TRUST
CERTIF.
PSECU provided the Department with the information below, which has been used in calculating the
potential tax due. Records 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, please obtain written correction from the financial institution, attach a cape 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) 7B7-8327 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 8203136752-S4 Date 02-11-2004 To ensure proper credit to the account, two
Established copies of this notice must accompany L
Account Balance $` 818 • 84 payable to "Register of Wills, Agent".
Percent Taxable X 16.667
NOTE: If tax payments are made within three
Amount Subject to Tax $ 136.48 months of the decedent's date of death,
Tax Rate X .045 deduct a 5 percent discount on the tax due.
Any Inheritance Tax due will become delinquent
Potential Tax Due $ 6 • 14 nine months after the date of death.
PART TAXPAYER RESPONSE
FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT ~
A.~The above information and tax due is correct. n `-~ ~
Remit payment to the Register of Wills with two copies of this notice to Ob~e-f~ ~
a discount or avoid interest, or check box "A" and return this notice to the ~~ter o~
C H E C K Wills and an official assessment will be issued by the PA Department of Revenue ~
C ONE ~ J ! ~1 ;
B L 0 C K B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania. ~gea~tance-T~c return '
ONLY to be filed by the estate representative. _ ..,~
._ • .
-. -.- r -~-T ~.
C. ~ The above information is incorrect and/or debts and deductions were paid. _ _...
Complete PART 2~ and/or PART ~ below. -~-i .~ '
- }
PART If indicating a different tax rate, please state OFFICIAL USE 0 Y ~ AAF
relationship to decedent: PA DEPARTMENT OF REVENUE
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
-I`:E 1. ^ate Est=_~lishad 3 ---- --
2. Account Balance 2
3. Percent Taxable 3 X
4. Amount Subject to Tax 4
5. Debts and Deductions 5
6. Amount Taxable 6
7. Tax Rate 7 X
8. Tax Due $ '~
PAD
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2
3
4
5
6
7
8
PART DEBTS AND DEDUCTIONS CLAIMED
0
nnTF PAID PAYEE DESCRIPTION AMOUNT PAID
Und~~enalties of perjury, I declare that the facts I have reported above are true, core
ca(p].~te lto the jre~t ~ my knowledge and belief . HOME C ~ ~ ) ~O Y~"- %cr7
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