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Home My WebLink About06-18-09 (2)COMMONWEALTH OF PENNSYLVANIA DEPM ~AE~~EVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280801 HARflISBURG, PA 17128-0601 RECEIVED FROM: PREDIX SARAH J 445 STATE STREET WEST FAIRVIEW, PA 17025 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1182 EX111-961 NO. CD 011373 ACN ASSESSMENT AMOUNT CONTROL NUMBER -------- 1o~d ESTATE INFORMATION: ssrt: t77-az-a5at FILE NUMBER: 2109-0571 DECEDENT NAME: PREDIX CATHERINE A DATE OF PAYMENT: 06/18/2009 POSTMARK DATE: 06/12/2009 couNTV: CUMBERLAND DATE OF DEATH: 09/20/2008 08148782 ~ S 12.28 TOTAL AMOUNT PAID: REMARKS: SARAH PREDIX SEAL CHECK#1686 INITIALS: WZ RECEIVED BY: S 12.28 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES i ` ;= '~j ~' AND FILE ND PD eox zaoaol ~` TAXPAYER RESPONSE ACN HARRISBURG PA 17128-0601 - ~ ~ ' °'t" DATE eav-isae sz uv toe-on t8 AhIIt143 ORPHAN S COlJR7 CUAFB~R!F,'VD rn PA. SARAH J PREDIX 445 STATE STREETT WEST FAIRVIEW PA 17025 21 ~ ~ -e"J7~ 08148782 10-13-2008 EST. OF CATHERINE A PREDIX SSN 177-42-4531 DATE OF DEATH o9-20-2008 COUNTY CUMBERLAND REMI7 PAYMENT AND FORMS T0: REGISTER OF WILLS CUMBERLAND CD COURT HOUSE CARLISLE, PA 17013 TYPE OF ACCOUNT SAVINGS ® CHECKING TRUST CERTIF. MEMBERS 1ST FCU Provided the Debsrtaent with the info raation below, which has bean used in ealculatinp the Potential tax due. Records indicate that at the tleath of the above-naaed decadent, you ware a joint owner/banal iciarv of Lois account. If you feel the intonation is incorrect. Please obtain written correction frog the financial institution, attach s eopv to this fora and return it to the above address. This account is taxable in aeeo rdanee with the Inheritance Taz laws of the Coro,wealth of Pennsylvania. Please call O17) 707-p327 with vuastton s. COMPLETE PART 1 BELOW ^ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 202128-1 1 Account Balance Percent 7axebl• Amount Subject to Tax Tax Rate Potential lax Due Data 02-20-2001 Establishetl $ 545.77 X 50.000 $ 272.89 X .045 8 12.28 Ta ensure Proper credit to the account. two copies pf this notice auat aeeeepero pavaent to the Rapistar of Wills. Make chock payable to "Rapistar of Wills, Apent". NOTE, If taz payaents era aade within three aonths of the de cedant's date of death, deduct a 5 Percent discount on the tax due. Anv Inhe ritanc• Tax tlue will become tlelinauant nine aonths after the data of death. A. M Tha sbova inforaation and tax due is correct. LJ Raait Dsb'aant to tho Rapistar of Wills with two copies of this noties to obtain CHECK s discount or avoid interest, or chock box •'A" end return this noties fo the Rapistar pf ONE ~ Wills end an official assessaent will be issued by the PA Departaent of Revenue. BLOCK B. ~ Tha sbova asset has been or will be reported and tax paid with the Pann sylvan is Inh eritenca Tax return ONLY to be filed by the estate rap resentativa. C. ~ Tha sbova info ~aeon is ineo rr et antl/or debts end deductions were paid. CoaPlet• PART IJ and/or PART 3~ below. pAR7 If lndicatinp a different tax rate, pl•as• state relationship to decadent: TAX RETURN - COMPUTATION OF TAX DN JOINT/TRUST ACCOUNTS LINE 1. Date Established 1 2. Account Balance 2 3. Portent TazeDlp 3 X 4. Amount Subjaet to Tax 4 S 5. Dehts and Datluetlona 5 6. Amount Taxable 6 S 7. Tax Rata 7 X 8. Tax Due 8 $ PART DATE PAID PAYEE DESCRIPTION WORK [71-7 T7(D~1 - AMOUNT PAID U ar ponalti es of perjury, I declare that the .facts I hay reported above era true, cor roet and cow late to the tCes t/Af my knorledp• and bell af. ~ / / i HOME C-tl1) ?J~q-~a7a ioo ~ :~oo Im ~NI~ W C ~ W ~a lid~~~ `~ ~,1~ ~~~~ N ~ N m iy aow ~11N(1 0 o f xp~ ~~~ ~~ d ~_ ~~~ ~~ Z S~ ~ '~ V r n V V ' J~~ L~~O V ~~ ~~ z ~ s ~S ~ C~ .} ~~ ~M l7 ~' ..-e