Loading...
HomeMy WebLinkAbout05-15-09 (2)COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX111-96) NO. CD 01 1243 DUPLICATE WEST DONNA L 7152 CO RD 56RT2 MOUNT GILEAD, OH 43338 fold ESTATE INFORMATION: ssN: 184-2s-5048 FILE NUMBER: 2109-0204 DECEDENT NAME: CLOUSER DAVID H DATE OF PAYMENT: 05/ 1 5/2009 POSTMARK DATE: 05/15/2009 couNTY: CUMBERLAND DATE OF DEATH: 02/20/2009 REMARKS: ACN ASSESSMENT AMOUNT CONTROL NUMBER 09117549 ~ 5320.91 09117546 ~ 5321.07 09117552 ~ 5305.58 TOTAL AMOUNT PAID: 5947.56 CHECK# 642 INITIALS: AJW SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU DF INDIVIDUAL TAXES AND FILE NO. 21 09-0204 Po BOX 280601 TAXPAYER RESPONSE ACN 09117549 NARRISBUR6 PA 17128-06fl1 REV-1543 EXI1Fp(OB-08) DATE 03-19-2009 TYPE OF ACCOUNT EST. OF DAVID H CLOUSER ~ SAVINGS SSN 184-26-5048 ~ CHECKING DATE OF DEATH 02-20-2009 ~ TRUST COUNTY CUMBERLAND~~ ~v-') 0 CERTIF. REMIT PAYMENT AND FORMS TO:C_:~ ~ DONNA WEST REGISTER OF WILLS -,~_ _~ ~~ 7152 COUNTY ROAD #56 CUMBERLAND CO COURT HOUSE ~~ "4 MT GILEAD OH 43338 CARLISLE, PA 17013 ~_~~ --- - 1 ,. i t-~~ ...,,~ , ..,~.~ ~V MEMBERS 1ST FCU provided the Department with the information below, which has been u`~ d in calculating the potential tax due. Records indicate that at the death of the above-named decedent, you were a joint owner/beneficiary of t~ account. If you feel the information is incorrect, please obtain written correction from the financial institution, attach a copy 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 Pe~wsyirania. Fitese call (717) 7n7-n3z7 with questions. -~- COMPLETE PART 1 BELOW ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 113054-41 Date 02-05-1990 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance $ 85, 579.74 payment to the Register of Wills. Make check payable to "Register of Wills, Agent". Percent Taxable )( 8.333 Amount Subject to TaX $ 7, 131 .36 NOTE: If tax payments are made within three months of the decedent's date of death, Tax Rate X . 045 deduct a 5 percent discount on the tax due. Potential Tax Due $ 320.91 Any Inheritance Tax due will become delinquent nine months after the date of death. PART TAXPAYER RESPONSE 1^ - I uRro sJaNn .~ a &;' A. ~ The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain CHECK a discount or avoid i nterest, or check box "A" and return this notice to the Register of 0 N E Wills and an official assessment will be issued by the PA Department of Revenue. B L 0 C K ~ 0 N L Y B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to b e 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 ~ below. . PART If indicating a different tax rate, please state relationship to decedent: TAX RETURN - COMPUTATION LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due OF TAX ON JOINT/TRUST ACCOUNTS PAp 1 2 3 X 4 5 6 7 X 8 I .....C1NLY .....~ ~AAF ~, REVENUE 1 2 3 4 6 7 „ ...: PART DEBTS AND DEDUCTIONS CLAIMED 0 DATE PAID PAYEE DESCRIPTION AMf111NT porn Under penalties of perjury, I declare that the facts I have reported above are true, correct and mplete to the best of my knowledge and belief. HOME C~ ~ ~ ) ~ ~.P a- ~o a a TAXPAYER ST[;NATIIRF WORKr^C~,rq„~"T~RC+ ~S ~`7 «~:~..r vn mane ~ or :ax computation) $ PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES AND FILE N0. 21 09-0204 Po Box 280601 TAXPAYER RESPONSE ACN 09117546 HARRISBURG PA 17128-0601 REV-1543IXAFP COB-OB) DATE 03-19-2009 TYPE OF ACCOUNT EST. OF DAVID H CLOUSER ^ SAVINGS SSN 184-26-5048 ^ CHECKING DATE OF DEATH 02-20-2.009 ^ TRUST COUNTY CUMBERLAND ~ CERTIF. r.) REMIT PAYMENT AND FORMS TO:;-~ DONNA WEST REGISTER OF WILLS yU `'O 7152 COUNTY ROAD #56 CUMBERLAND CO COURT HOUSE- _ .,._ ~. MT GILEAD OH 43338 CARLISLE, PA 17013 -_-~~ "`= ' ' rt _.._ _ ~:'~ ~~ - _ -- !. -*7 - ... MEMBERS 1ST FCU provided the Department with the information below, which has been u d-in calcula~bing the potential tax due. Records indicate that at the death of the above-named decedent, you were a joint owner/berriciary of this account. If you feel the information is incorrect, please obtain written correction from the financial institution, attach 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 Commonwealth of Pennsylvania. Please call C717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 1 1 3054-4 0 Date 12-14-2005 To ensure proper credit to the account, two Established copies of this notice must accompany 85, 622.33 payment to the Register of Wills. Make check Account Balance $ payable to "Register of Wills, Agent". Percent Taxable X 8.333 NOTE: If tax payments are made within three Amount Subject to Tax $ 7, 134.91 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 $ 321.07 nine months after the date of death. PART TAXPAYER RESPONSE 1^ LURE ~'EO 5P0 W L T OF C E NTi A. ^ The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain CHECK a discount or avoid interest, or check box "A" and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. C ONE B L 0 C K 0 N L Y B. ^ The above asset has been to be filed by the estate or will be reported and tax paid with the Pennsylvania Inheritance Tax return representative. C. ^ The above informs ion is Complete PART ~2 and/or incorrect and/or debts and deductions were paid. PART 3^ below. PART If indicating a different tax rate, please state relationship to decedent: TAX RETURN - COMPUTATION LINE I. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Taz 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due OF TAX ON JOINT/TRUST ACCOUNTS PAD 1 2 +~ 3 X 4 5 6 7 X 8 PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported above are true, correct pand/~ co ete to the best of my knowledge and belief. HOME Cy ~ ~ ) ~ ~ a `";~O ~i. eh c~ _ i9-~o~ ~, ~~,~ WORK C~ I ~) ~_~ ~ ~ ~ ~ '~( =~ ~ " D l IOIAL CEnter on Line 5 of Tax Computation) $ PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES AND FILE N0. 21 09-0204 PO BOX 280601 TAXPAYER RESPONSE ACN 09117552 HARRISBURG PA 17128-0601 DATE 03-19-2009 REY-1543 EX AFP C08-0e) TYPE OF ACCOUNT EST. OF DAVID H CLOUSER ^ SAVIN SSN 184-26-5048 ^ CHECK DATE OF DEATH 02-20-2009 ^ TRUST COUNTY CUMBERLAND ^ CERTI REMIT PAYMENT AND FORMS T0: ~..,~ c~ DONNA WEST REGISTER OF WILLS C7 7152 COUNTY ROAD #56 CUMBERLAND CO COURT H0~1,S~ - _ MT GILEAD OH 43338 CARLISLE, PA 17013 '~~-~, 1[_;-~~ --G _ - ;-T-t -- - ~ - ~~ - ' C"- ~ c7 -~ - - _•, _ ~ - MEMBERS 1ST FCU provided the Department with the information below, which has been usel'~ calcul~g the-~ potential tax due. Records indicate that at the death of the above-named decedent, you were a ioint owner/benefiL~ry of t account. If you feel the information is incorrect, please obtain written correction from the financial institution, att-~h a copy to~bis form' and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Commanwealt~f "rennsylvania. Flease call CiI7J 7b7-8327 wiih questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS GS ING F. Account No. 1 1 3054-42 Date 08-11-2004 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 $ 81 , 491.13 payable to "Register of Wills, Agent". Percent Taxable X 8.333 Amount Subject NOTE: If tax payments are made within three to TaX $ 6 790 66 , . months of the decedent's date of death, Tax Rate X .045 deduct a 5 percent discount on the tax due. Potential Tax Any Inheritance Tax due will become delinquent Due $ 305.58 nine months after the date of death. P RT TAXPAYER RESPONSE A ~FAI' Tao WILL RESULT - SMEtiT A. ^ The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain CHECK a discount or avoid interest, or check box "A" and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. C 0 N E ~ 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 3^ below. PART If indicating a different tax rate, please state relationship to decedent: TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD LINE 1. Date Established 1 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due I- ~. AA F PA DEPARTMENT 0 NIIE 1 2 4 5 6 ~ r 1~ ~° z $ 3 X 4 5 - 6 7 X 8 +~ PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID TOTAL CEnter on Line 5 of Tax Computation) B Under penalties of perjury, I declare that the facts I have reported a /ove are trl!ue, correct~Jand Mete to the best of my knowledge and belief. HOME ( ) l.Q ~ " v 1 .F,___.,. ~. I~ WORK C ~~ ~ S~ - iU~O -I/-©c r+• ~~ ~:.? r• t,~~ ri1 u1 Ya iti Cy C.~ r~^ ter, ©~~ ~ ~ ~~ i o~ ~? ~ ~ C~ ,.. :41~ ~~ _ ~ lit ,~_ ~% . !`jai `~i:~~i ~!; N .~ Q~~ yy M, ,` , :~. S (', ~~..~ H ~ ~ .`. ~_ ' o ss ~ 'i is vsn ,~ s~~ e vsn 3 3 y/5, Y Y ®~