HomeMy WebLinkAbout07-08-09COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG. PA 1 7 7 28-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
N0. CD 01 1460
SNYDER KELLY
1 150 W FERN APT 9
COAL TOWNSHIP, PA 17866
fold
ESTATE INFORMATION: ssN: oo0-00-0000
FILE NUMBER: 2109-0630
DECEDENT NAME: DUPNACK DECOKES A
DATE OF PAYMENT: 07/08/2009
POSTMARK DATE: 07/07/2009
couNTY: CUMBERLAND
DATE OF DEATH: 04/22/2009
REMARKS:
CHECK# 2639
SEAL
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
09137820 ~ S 190.91
TOTAL AMOUNT PAID:
INITIALS: CJ
REV-1162 EXI11-96)
S 190.91
RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
BUREAU OF INDIVIDUAL TAXES AND FILE N0. 21-V''1•C1~c31)
Po Box 2BObo1 ~ •TAXPAYER RESPONSE ACN 09137820
HARRISBURG PA 17128-0601 - -
REV 4543 ;E~,p~p(Y ~-oaa' ~~ '~•~~~• DATE 06-19-2009
2409 JU! -8 ~M i i = i t
l~i~~{1~~ ~f
o~~c~a~ s ~n;~RT
KELLY SNYDER
17 GRANDE AVE
ELYSBURG PA 17824
EST. OF DELORES A DUPNACK
SSN 182-28-7350
DATE OF DEATH 04-22-2009
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS TD:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
TYPE OF ACCOUNT
SAVINGS
® CHECKING
TRUST
CERTIF.
SUSQUEHANNA BANK provided the Department with the information below, which has been used in calculating the
potential tax due. Records indicate that at the death of the above-named decedent, You were a joint owner/beneficiary of this 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
Pennsylvania. i"I ease tail C717) 787-8327 with questians.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 3108914809 Date 03-13-1996 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 $ 2, 679.48 payable to "Resister of Wills, Asent".
Percent Taxable X 50.000
NOTE: If tax payments are made within three
Amount Subject to Tax $ 1,339.74 months of the decedent's date of death,
Tax Rate X , lrj deduct a 5 percent discount on the tax due.
Any Inheritance Tax due will become delinquent
Potential Tax Due $ 200.96 nine months after the date of death.
PART TAXPAYER RESPONSE
FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT
A. ~ The above information and tax due is correct.
Remit payment to the Register of Wills with two copies of this notice to obtain
C H E C K 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.
ONE
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 information 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 OFFICIAL USE ONLY ~ AAF
relationship to decedent: PA DEPARTMENT OF REVENUE
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD
LINE 1. Date Established 1 1
2. Account Balance 2 $ 2
3. Percent Taxable 3 X 3
4. Amount Subject to Tax 4 $ 4
5. Debts and Deductions 5 5
6. Amount Taxable 6 $ 6
7. Tax Rate 7 X 7
8. Tax Due 8 $ 8
PART DEBTS AND DEDUCTIONS CLAIMED
3^
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
TOTAL CEnter on Line 5 of Tax Computation) 8
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. HOME C`.,~1(~ ) ~:~,~-~i'-tl^~~
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