HomeMy WebLinkAbout01-29-08COMMONWEr4LTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF IPJDIVIDUAL TAXES
DEPT.28060'I
HARRISBURG, PA 1 7 1 28-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1162 EX~11-96)
NO. CD 010694
WITHINGTON SANDRA
1200 INDIAN CAMP RUN
YOUNGGSVILLE, PA 16371
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ESTATE INFORMATION: SSN: 205-12-4599
FILE NUMBS.R: 2108-1221
DECEDENT NAME: GALBRAITH MELVIN
DATE OF PAYMENT: 1 2/ 29/ 2008
POSTMARK DATE: 1 2/23/2008
couNTY: CUMBERLAND
DATE OF DEATH: 08/09/2008
REMARKS:
CFiECK# 2424
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
08161342 ~ $48.17
TOTAL AMOUNT PAID: $48.17
INITIALS: AJW
SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE 1
AND FILE N0. 21 ~~ ~aa'\
BUREAU OF IFIDIVIDUAL TAXES
Po Box zao6111 TAXPAYER RESPONSE ACN 08161342
HARRISBURG F'A 17128-0601
DATE 12-15-2008
REV-1543 EX AFP (09-097
TYPE OF ACCOUNT
EST. OF MELVIN GALBRAITH ~ SAVINGS
SSN 205-12-4599 ® CHECKING
DATE OF DEATH 08-09-2008 ~ TRUST
COUNTY CUMBERLAND ~ CERTIF.
REMIT PAYMENT AND FORMS T0: ~"=a
j
SAtJDRA G WITHINGTON REGISTER OF WILLS ~_-~~ ''='
1200 INDIAN CAMP RUN CUMBERLAND CO COURT HQU~~ "~
YOIJNGSVILLE PA 16371-3626 CARLISLE, PA 17013 -- ,,
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NATIONAL C[TY BK OF PA provided the Department with the information below, which has been~usarY in calcRlAting the'
potential taX: due. Records indicate that at the death of the above-named decedent, you were a joint owner/b~nef~iciary of~{his account.
If you feel t:he information is incorrect, please obtain written correction from the financial institution, mach a copy ~ this form
and return ii: to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Commonweal-k~ of
Pennsylvania. Please cz11 !71?~ 7B7-8327 with nuestions.
COMPLETE PART I BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 3168010 Date 05-02-1996 To ensure proper credit to the account, two
Established copies of this notice must accompany
payment to the Register of Wills. Make check
Account Balance ~` 1,926.75 payable to "Register of Wills, Agent".
Percent Taxable X 16.667
NOTE: If tax payments are made within three
Amount' Subject to Tax $ 321 13 months of the decedent's date of death,
Tax Raate ~( , 1 ~j deduct a 5 percent discount on the tax due.
AnY Inheritance Tax due will become delinquent
Potential Tax Due $ 48 • 17 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.
Remit payment to the Register of Wills with two copies of this notice to obtain
a discount or avoid interest, or check box "A" and return this notice to the Register of
C H E C K 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 estate representative.
C. ~ The above informs 7.on is incorrect and/or debts and deductions were paid.
Complete PART 2~ and/or PART ~ below.
PART If indicating a different tax rate, please state
relationship to decedent:
AX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD
T
LINE I.
Date Establishes
i
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2. Account Balance 2 $ ~~~LO '7~
3. Percent Taxable 3 X l L ' ~ ~
4 Amount Subject to Tax 4 +fi ~a, l •
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3
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5. Debts and Deductions 5 '~"~"'
6. Aimount Taxable 6
7. Tax Rate 7 X
8. Tax Due 8 '~ "'
PART
DATE PAID PAYEE
OFFICIAL USE ONLY ~ AAF
PA DEPARTMENT OF REVENUE
2
3
4
5
6
7
8
DEBTS AND DEDUCTIONS CLAIMED
DESCRIPTION
AMOUNT PAID
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Under penalties of perjury, I declare that the facts I have reported above are true, corr[~e,ct /and ' /
c mplelIt,~el~~o~~//the b~~jj/~s~~t o my knowledge and belief . HOME C ~ ~ ~ ) `~ L ~/' '" / ~! ~ `7
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