HomeMy WebLinkAbout05-27-09COMMONWEALTH 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 1285
WINTERS CHARLENE
101 LONGVIEW DRIVE
SHIPPENSBURG, PA 17257
-------- told
ESTATE INFORMATION: ssrv: i as-22-7935
FILE NUMBER: 2109-0489
DECEDENT NAME: WINTERS CHARLES
DATE OF PAYMENT: 05/27/2009
POSTMARK DATE: 05/26/2009
couNTY: CUMBERLAND
DATE OF DEATH: 03/25/2009
REMARKS:
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
09124521 ~ 58.17
TOTAL AMOUNT PAID:
58.17
CHECK# 5214
INITIALS: AJW
SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
PENNSYLVANIA INHERITANCE T
INFORMATION NOTICE
BUREAU OF INDIVIDUAL TAXES AN D
PO BOX 280601
HARRISBURG PA 17128-0601 TAXPAY E R R E S P O N S E
REV-1543 EX AFp (OB-OB)
CHARLENE WINTERS
101 LONGVIEW DRIVE
SHIPPENSBURG PA 17257
FILE N0. 21 ~°~ 0~~'
ACN 09124521
DATE 04-15-2009
EST. OF CHARLES WINTERS
SSN 186-22-7935
DATE OF DEATH 03-25-2009
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
TYPE OF ACCOUNT
® SAVINGS
CHECKING
TRUST
CERTIF.
rv
C7 ~ -
MEMBERS 1ST FCU
potential tax due. Records indicate tha _:~.
_~ ~ ~
provided the Department with the information below, which has been useiK grr colt ling the `~'
t at the death of th
b
If you feel the information is incorrect e a
ove-named decedent, you were a ioint owner/beng~~ry o is aecounC~,
, Dlease obtain written correction fr
th
f
and return it to the above address. Thi om
e
inancial institution, attd:4h ra:;capythis forme"
s account is taxable in accordance with th
I
e
nheritance Tax laws of fbq--C~~mgonwea~l
Pennsylvania. Please call (717) 787-8327 with questions.
th of
-~
COMPLETE PART 1 BELOW ~ ~
_ _
SEE REVERSE SIDE FOR FILING AND PAYMENT INST TIONS~-
Account No. 49612-00 Date 03-14-1986 ~- '•
Ta ensure proper crept to the ac~Qnt, two
Established
Account Balance copies of this notice must accomp~
$ 363.10 payment to the Register of Wills. Make check
Percent Taxable payable to "Register of Wills, Agent".
X 50.000
Amount Subject to Tax $ 181.55 NOTE: If tax payments are made within three
Tax Rate months of the decedent's date of death,
~(
.045 deduct a 5 percent discount on the tax due
Potential Tax Due .
$ $ 17 Any Inheritance Tax due will become delinquent
PART nine months after the date of death.
0 ,__~ ..__ ~_ _ TAXPAYER RESPONSE
~ A
CHECK
C ONE
BLOCK
ONLY
_~ inrormacion 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
Wills and an official assessment will be issued by the PA Department of Revenue.
B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
to be filed by the estate representative.
C. ~ The above informs ion is incorrIe~ct and/or debts and deductions were paid.
Complete PART ~2 and/or PART ~a ~ below.
PART if indicating a different tax rate, please state
a 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
1
2
3 X
4 +~
5 -
6 +fi
7 X
8 $
f~FFICI SE ~#.Y AAF
A°'zH~PA Off' RAVEN(
A
i
2
3
4
5
6
7
PART
DATE PAID PAYEE
DEBTS AND DEDUCTIONS CLAIMED
DESCRIPTION
AMOUNT PAID
TOTAL CEnter on Line 5 of Tax Computation) g
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
complete to the best of my knowledge and belief. ~~ n 3~~
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TAXPAYER ST[`NOTIiRF
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