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HomeMy WebLinkAbout08-18-09COMMONWEALTH OF PENNSYLVANIA DEPARTMEN7 OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280801 HARRISBURG, PA ti12B-0801 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT HORNEYS CAROLE J 1325 W INDIGO DRIVE MT PROSPECT, IL 60056-1546 REV-1182 EX~71-96) N0. CD 011637 ACN ASSESSMENT AMOUNT CONTROL NUMBER ESTATE INFORMATION: SSN: 480-60-4009 FILE NUMBER: 2109-0772 DECEDENT NAME: HORNEYS JOHN W DATE OF PAYMENT: OS/1S/2009 POSTMARK DATE: 08/15(2009 COUNTY: CUMBERLAND DATE OF DEATH: 06/01/2009 09146816 ~ 5282.44 TOTAL AMOUNT PAID: REMARKS: SEAL CHECK# 3147 INITIALS: CJ RECEIVED BY: S 282.44 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS PENNSYLVANIA INHERITANCE T INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES _ AND PG Hox zaosHl ( ''r'' TAXPAYER RESPONSE IURRIS BURG PA 17128-0601 -,- ' eavgsH', F1G,Rij[PatVS, ~' ~ , FILE N0. 21'~-D17~ ACN 09146816 DATE 06-12-2009 2oa~ auc i s p~ i2~ 2s CLERK ~~ ORPHAN'S C~OIJRT CUP~'~ -~i . ~, ~~,~. PP. CARDLE J HORNEYS 1325 W INDIGO DR MT PROSPECT IL 60056-1546 EST. OF JOHN W HORNEYS SSN 480-60-4009 DATE OF DEATH 06-01-2009 COUNTY CUMBERLAND REMIT PAYMENT AND FORNS TD: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST © CERTIF. PNC HANK NA provided the Oepartaent with the infareation below, which has been usatl in calculating the pa tential fax due. Raeortls indicate that at the death of khe above -naaed tlecetlent, you were a joint owns r/benef iei cry of this account. If you feel the info reatian is incorrect, please obtain written correction from the financial institution, attach a copy ko this fora and rekurn 14 to the above address. This account is 4ax able in deco rdence with the Inheritance Tss laws of the Laamoriwealth of Pennsylvania. Plesae call (717) 787-8327 with questions. COMPLETE PART 1 BELOW N SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Recount No. 000021001 057500 Date 07-13-1995 Ta ensure proper craait to the account, two Estab l3 shed copies of this notice ausk aceoepaM Account Halanee S 13 212 14 paveent to the Repis4 er of Nills. Naka cheek , . payable to ••Reviskar of Wills, Agent". Percent Taxable X 50.000 Amount Subyect to Tax ;' 6 606 07 N-7E: If taz pavaents are made within three . , nonths of the decetlent's data of death. Tex Rate X . 045 deduct a 5 pe reent discount on the tax due. Potential Tax DW $ 297 27 Ary Inheritance Tax due will beeoee de linouent . _ nine aonths of tar the tlate of death. ppR7 If SntllcatinH a tl3ffore nt l, tax rate, Ale ass state i' ~~J" '~~'Ji~~ ~" relationship to dated ont: ~ f ~ I. TAX RE TURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS 'I LINE 1. Date Established 1 ~~~ 2. Account Halanee 2 S 3. Pere ant Taxable 3 X 4, Amount Sub3ect to Tax 4 S 5. Debts antl Detluetions 5 6. Amount Taxable 6 7. Tax Rate 7 X e, Tex Dua a +~ PART DEBTS AND DEDUCTIONS CLAIMED 3 DATE PAID PAYEE DESCRIPTION AMOUNT PAID Untler penalties of perjury, I tleelar• that the facts I have reported above are true, torte et antl complete to th• bast of my Knowletlae and belief. HOME C ) WORK ( ) TAXPAYER SIGNATURE TELEPHONE NUMBER DATE ~~ r•. ~:. ~#~ a~ 9~~ (jY r m n 20C4 AUG 18 PH 12~ 2~ x CLERK OF ORPHA~'d'S CURT CUME.~~, ~,,;r; r` n ~A n ~~ ,~ i {~ g