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Home My WebLink About12-29-08COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT.28060~1 HARRISBURG, PA 17128-0601 RECEIVED FROM: HARVEY JUNE K 1860 HOLLY DRIVE CAMP HILL, PA 17011 -- fold ESTATE INFORMATION: ssN: FILE NUMBER: 2108- 1 282 DECEDENT NAME: STARNER KATHY H DATE OF PAYMENT: 1 2/ 29/ 2008 POSTMARk: DATE: 1 2/27/2008 couNTY: CUMBERLAND DATE OF DEATH: 1 O/ 1 3/2008 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 ~ 55.42 TOTAL AMOUNT PAID: REMARKS: CHECK# 181 1 SEAL PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT INITIALS: AJW RECEIVED BY: 55.42 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REV-1162 EX111 96) NO. CD 010696 REGISTER OF WILLS PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES AND FILE N0. 21 ~~ `2~~ PD BOX 280601 TAXPAYER RESPONSE ACN 08163380 HARRISBURG IPA 17128-0601 DATE 12-23-2008 REV-1543 Ex AFP (OB-OB) TYPE OF ACCOUNT EST. OF KATHY H STARNER ~ SAVINGS SSN ® CHECKING DATE OF DEATH 10-13-2008 ~ TRUST COUNTY CUMBERLAND ~ CERTIF. REMIT PAYMENT AND FORMS T0: JUNE K HARVEY REGISTER OF WILLS - --, 1860 HOLLY DR CUMBERLAND CO COURT HODS-E"~ ~.:~ CAMP HILL PA 17011 CARLISLE, PA 17013 - `, ='~ ~.~ - _., SOVEREIGN BANK provided the Department with the information below, which has been usedfH1 calcula~g the potential ta:x due. Records indicate that at the death of the above-named decedent, you were a joint owner/bene#-~ci3ry of this account.. . If you feel the information is incorrect, please obtain written correction from the financial institution, attae7~ a copy to[~is form and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Commonwealti{~f Pennsylvania. Please call (717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 0571116868 Date 06-07-2002 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 $ 722 • 93 payable to "Register of Wills, Agent". Percent Taxable X 16.667 NOTE: If tax payments are made within three Amount Subject t0 Tax $ 120 • 49 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 $` 5 • 42 nine months after the date of death. PART TAXPAYER RESPONSE FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMEN? 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 ion is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART 3LJ below. PART I:f indicating a different tax rate, please state relationship to decedent: TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Date Established i 2. Account Balance 2 '~ 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. l-ax Rate 8. Tax Due 3 X 4 5 - 6 '~ 7 X 8 $ OFFICIAL U5E PA DEPARTMENT OF ONLY ~ AA~i` REVENUE PAD 1 2 3 4 5 6 7 8 PART nwrn PAVFF DEBTS AND DEDUCTIONS CLAIMED DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported above are true, 'correct and complete to the best or/~ knowledge and belief. HOME ~~~ T ~ ~l/~~ t~~~1: ~~1~i5.~./~J WORK C ) IJIIMA '~ N Q [^ d o ~~ ~ as ~ ~~ d~ 0 ~~ ~~ °~"° U ~. N m 0 ~ M ~ C ~ ~ r ~ o ~ . r- r ~i-a v Q ova ~ ~ ~i ~~ ~ ~..~ ~ .~, a~ ~~~~, ~~~ ~VU ((''~~ '_~V ~y~; ~~ . r ~ `r ^ y.. ,..~ ~~•s ~`; ti .~.. i''! ..F l,.S ~•.,. ;i..y ~~ ,Z ~~~ r~ ~,