HomeMy WebLinkAbout12-22-08COhnm010~/~LTH OF PENNSYLVANIA REV-1 7 62 EX~ 1 1-961
DEPARTMENT OF REVENUE
BUREAU OF INDNIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1]128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
N0. CD 010671
THOMAS CONNIE
2 BOURON RED DRIVE
MECHANICSBURG, PA 17050
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
mm
ESTATE INFORMATION: SSN: t63-tz-5ot2
FILE NUMBER: 2108-1251
DECEDENT NAME: TITUS WAYNE H
DATE OF PAYMENT: 12/22/2008
POSTMARK DATE: 12/19/2008
COUNTY: CUMBERLAND
DATE OF DEATH: 06/14/2008
REMARKS: JAMES THOMAS
SEAL
CHECK#726
08160922 56.14
TOTAL AMOUNT PAID:
56.14
INITIALS: WZ
RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
BUREAU OF INDIVIDUAL TAXES AND FILE ND
PD Box zeg sBl - TAXPAYER RESPONSE ACN
IVIRRIS BURG PA 1]128-0601 -
GATE
PFV-1545 E% IFr (00-OG)
21~- ~a - ~ as ~
08160922
12-11-2008
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CONNIE L THOMAS
2 BOURBON RED DR
MECHANICSBURG PA 17050
EST. OF WAYNE H TITUS
SSN 163-12-5012
DATE OF DEATH 06-14-2008
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
TYPE OF ACCOUNT
SAVINGS
® CHECKING
TRUST
CERTIF.
PSECU pravi ded the Oepa rtn ent with the inf orn often below, which has been usetl in calculating the
potential tax due. Records indicate the[ at the tleath of the above-vaned tlecedent, you were a joint owner/beneficiary of this account.
If you teal the inf orn alien is inc orrectr please obtain written correction fran the financial instikuti on, attach a copv to this form
and return it to the above atld ress. This account is taxable in acco rtlan ce with The Inheritance Tax laws pf the Commonwealth of
Pennsylvania. Please call (717) 78]-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 at this notice must accon panv
pavment to the Register of Wills. Make check
Account Balance $ 818 • 84 pavabla to ''Register of Wills. Agent".
Percent Taxable X 16.667
NOTE: If taz paynents era node within Three
Amount Subject tp Tax $ 136.48 nonths of the decedent's date of death,
Tax Rate X . 0 4 5 deduct a 5 percent discount on The Tax due.
Any Inheritance Tax tlue will becone delinquent
Potential Tax Due $ 6.14 nine nonths attar the date of tleath.
PART TAXPAYER RESPONSE
^ ., , . ,.. n , e~e P ,.. s
,,,___,,,LLL,, ~a. a ., , .
A. T( ~ Tha above inf ormakion and tax due is correct. e v
.µ~\ Renik pavnent ko the Register of Wills with two copies of this notice to obtain
C H E C K a discount or avoitl interest, or check bpx "A" and return this npti ce to the Register of
r Wills antl an of ticial assessn ent will be issued by the PA Oepa rtnent of Revenue.
I ONE
L BLOCK B. ~ The above asset has been or will be reportetl antl tax paid with the Pennsylvania Inheritance Tax return
0 NL Y to be fil etl by the estate represent alive.
L. ~ The above inf orma ion is incorrect and/or debts and deductions were poi tl.
Conplete PART ~ and/or PART ~ below.
., eee ee , ee m
PART If indicating a different tax rake, please state °~~
i~ 4
relationship to decedent: ,. ~ : 4hy ~~~~ ~ ~~~~
A
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUS COUNTS ~' raw E: :Sa~atf~s,eth :kP ~~"~`, ~' ar ~~~"~"~
v
LINE 1. Cate Established 1 ~-.~" ~~ ~: ~~I~~;4'e~~ ~~"ei°i=k~be,w¢ ~~'~ a
2. Account Balance 2 +fi ~ ~r a ~'lv~M; ~ ~ ¢ a
E, ~ "~y
: '~w µoS~ a ~, d e a ~ ,~~~
3. Percent Taxable 3~~ r~~o ~~`~ ~ ~ ~yt~I~~~~jg~~~y~.
,r
4. Amount Subject to Taxes'-~~4 ~ : ~~ ~~¢e~a 44 ~
5. Debts and DedyaYlons 5 ~ ~ ~ a~h~~a ~ax't ~~ °~ ,&
6. Amount TzXable 6 $ em ~ ,.. '
7 iU~-Rate 7 X a ~- e
a ~a
8. Tax Due 8• $ ~~~~ a@ _ ,
PART DEBTS AND DEDUCTIONS ttAIMEIL--"-
___
DATE PAID PAYEE -.- ~ ~ DESCRIPTION AMOUNT PAID
TOTAL (Enter on Line 5 of Tax Computatlon7 8
Under penalties of perjury, I declare that The tacks I have reportetl above are true, correct and
X complete to the bgs of m knowledge and belief. HOME C ~~1 ) ~ ~- 4
~~~i WORK C 111 ) L~j- (oNOU ~- I~ O~
PAYER SI TDR'~ ~ TELEPHONE NDMBER DATE
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