HomeMy WebLinkAbout02-09-09r
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
o EPT.,)SBa01~
HARRISBURG. PA 1 ] 126-0601
RECEIVED FROM:
PRUCNAL MARY A
11 OAKWOOD AVENUE
MECHANICSBURG, PA 17055
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1162 EX~11-961
NO. CD 010879
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
cola
ESTATE INFORMATION: SsN: 2os-tz-5sts
FILE NUMBER: 2109-0142
DECEDENT NAME: DAYTON MARTHA M
DATE OF PAYMENT: 02/09/2009
POSTMARK DATE: 02/09/2009
COUNTY: CUMBERLAND
DATE OF DEATH: 11 /29/2008
REMARKS: MARY PRUCNAL
SEAL
CHECK#5227
08165158 ~ $4,537.23
TOTAL AMOUNT PAID:
INITIALS: WZ
RECEIVED BY:
54,537.23
GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE ~~~
AND FILE N0, 21 - ~~
BUREAU OF INOIVIOUAL TAXES ACN 08165158
PG Box zggsBl _ TAXPAYER RESPONSE
HARRISBURG PA ntzB-gaol _ - DATE 12'29'2008
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209 FED -9 PN 3~ 25
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(`~IA~RP {!F~`:~ !;',IURT
MARY A PRUCNA'L
11 OAKW000 AVE
MECHANICSBURG PA 17055-4730
EST. OF MARTHA M DAYTON
SSN 209-12-5919
DATE OF DEATH 11-29-2008
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
TYPE OF ACCOUNT
® SAVINGS
CHECKING
TRUST
CERTIF.
PNC BANK NA vrovitled the Oeoa rtnent with khe information below. which has been used in calculating the
votential tax due. Records indicate that at the death of the above-named decedent, you were a ioint owner/banef iciarY of this account.
If You feel the inf ormakion is incorrect, pl ease obtain wrikken correction from the financial institukion, aktach a copy to this term
and return it to the above address. This acboumt is taxable in accordance with the Inheritance Tax laws of the Commonwealth of
PennsYivana a. Fiease coal ~iiii 7B /'g3Z/ witn questions.
COMPLETE PART 1 BELOW ^ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 000005030008997 Dake 01-01-1979 To ensure proper credit to the a<count, two
copies of this notice rust accom pant
Established payment to the Register of Wills. Make check
Account Balance ~` 63,6$0.39 paY able to "Register of Wills. Agent".
Percent Taxable X 50.000
NOTE: If tax pavn ents are made within three
Amount SUbiecY to Tax y` 31:$40.20 months of khe decedent's dake of death.
1 rj deduct a 5 percent discount on khe tax due.
Tax Rate ~( , Anv Inheritance Tax due will become delinquent
Potential Tax Oue $ 4:776.03 nine months after the date of Beath.
PART ~ ^^r ^' -
A. s
7 he above inf orn ation and tax due is correct.
~
Ranik vaYment to khe Register of Wills wikh two copies of this notice to obtain
a discount or avoid inkaresk~ or check box "A" and return this notice to khe Register of
r CHECK Wills and an official assessment will be issued by the PA Department of Revenue.
I ONE
L BLOCK B . ~ The above asset has been or will be revorted and tax paid with the Pann sY lvania Inh Brit ante Tax rata rn
ONL Y to be filed by the estate representative.
C . ~ The above inf orma ton is incorrect and/or debks and tleduckions were paid.
Complete PART ~2 and/or PART ~ below.
PART If Sndicatin9 a different tax rate, please state a.. Te a..
2 rel ationship Yo decedent:
TAX RETURN - COMPUTATION
LINE 1. Date Established
2. Account Balance
3. Percent Taxable
4. Amount Su bj eet to Tax
5. Debts and Deductions
6. Amount Taxable
7. Tax Rate
8. Tax Due
OF TAX ON JOINT/TRUST ACCOUNTS
2 $
s X
5
6 $
T X
PART
^3
DATE PAID PAYEE
DESCRIPTION AMOUNT PAID
TOTAL (Enter on Line 5 of Tax Computationl e
Under penalties of perjury. I declare that the facts I O Ve
have reported a-b t and
r u e
are ~t
, co\r r~ejo
cmmplate to the h¢st of my knowledge and beli¢f. T
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DATE
DEBTS AND DEDUCTIONS CLAIMED