HomeMy WebLinkAbout07-14-09 (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
NO. CD 011483
BHUT SAROJ S
69 W VINE STREET
SHIREMANSTOWN, PA 01701-0001
told
ESTATE INFORMATION: ssN: is2-58-2500
FILE NUMBER: 2109-0645
DECEDENT NAME: BRUT SURESH D
DATE OF PAYMENT: 07/ 14/2009
POSTMARK DATE: 07/14/2009
couNTY: CUMBERLAND
DATE OF DEATH: 01 /2$/2009
REMARKS:
CHECK# 3522
SEAL
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
09141430 ~ S 138.87
TOTAL AMOUNT PAID:
INITIALS: CJ
REV-1162 EX111-96)
S 138.87
RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
BUREAU OF INDIVIDUAL TAXES - - -_ AND FILE N0. 21°(~~~~~
PD Box zao6ol TAXPAYER RESPONSE ACN 09141430
HARRISBURG PA 17128-0601
~ ~.." +,,, DATE 06-29-2004
REV-1543 E% AFP (08-de)
2~~9 ~~~ ( 4 P~4 1= ! 0
C' =~K OF
0~~ ~_ ~.,,'S ~dURT
NIKHIL S BHUT
69 PINE ST
SHIREMANSTOWN PA 17011-6345
EST. OF SURESH D SHUT
S5N 182-58-2500
DATE OF DEATH 01-28-2009
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
TYPE OF ACCOUNT
® SAVINGS
CHECKING
TRUST
CERTIF.
PNC BANK NA provided the Department with the information 6elow> which has been used in calculating the
potential tax due. Records indicate that at the death of the above-named decedent, you were a ioint 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. Please call C717) 787-8327 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 000005001134214 Date 01-29-1998 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 $ 6
171
89 "
,
. Day able to
Register of Wills, Agent".
Percent Taxable X 50.000
Amount Subject to TaX $
3
085
95 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
$ 1 3 $ . 8 7 Any Inheritance Tax due will become delinquent
nine months after the date of death.
P
T TAXPAYER RESPONSE
~
1
~
FJI~~Lt~2E T =ESROI~D WILL RESULT IN AN OFF ICIAL TAX ASSESSMENT
A. [~I The above information and tax due is correct.
L~JI 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
C 0 N E ~ Wills and an official assessment will be issued by the PA Department of Revenue.
BLOCK 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 ^PgFXC~~A~. USE (3NLY AAF`
relationship to decedent: PA DEPARTMENT OF REVENUE
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS pAD
LINE 1. Date Established 1~,2° q ~ I 1 ^ ~ ~
2. Account Balance 2 $ ~ ~ ~ ~ o ~ ~ I` 2 '
3. Percent Taxable 3 X ~• ~ ~ 3
4. Amount Subject to Tax 4 $ ~~~i•~ 4
5. Debts and Deductions 5 S
6. Amount Taxable 6 $'hC1~ •~ 6
7. Tax Rate 7 X ~~~{ j 7
8. Tax Due g _ $ ~~~. g / B
PART DEBTS AND DEDUCTIONS CLAIMED
0
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
comp ete t the b st of my knowledge and belief.
HOME C71 7 7 `i)r,_ 3~i? r
~' ~ r ~ ~ WORK C`71 -7 1 °l7 - 3°t-2 2 0
AX AYER SIGNATUR TELEPHONE NUMBER DATE'
TOTAL (Enter on Line 5 of Tax Computation) S
1Q09 JUL 14 PM f ~ 5 5
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