HomeMy WebLinkAbout10-01-09COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 7 7128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ACN
ASSESSMENT
CONTROL
NUMBER
NO. CD 01 1822
BARKLEY RUTH D
41 LENWOOD PARK
SHIPPENSBURG, PA 17257
told
ESTATE INFORMATION: ssrv: ~ ss-o3-~so4
FILE NUMBER: 2109-0925
DECEDENT NAME: YOHN THELMA A
DATE OF PAYMENT: 1 0/01 /2009
POSTMARK DATE: 10/01 /2009
COUNTY: CUMBERLAND
DATE OF DEATH: 07/04/2009
REV-1162 EX111-96)
AMOUNT
09155549 ~ 5183.22
TOTAL AMOUNT PAID:
REMARKS:
CHECK# 6446
SEAL
INITIALS: CJ
RECEIVED BY:
5183.22
GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
PENNSYLVANIA INHERITANCE T
INFORMATION NOTICE
AND
BUREAU OF INDIVIDUAL TAXES ''~.!`'`.-,, ._. ~.(,i:,.T pX P AY E R R E S P O N S E
PO 80X 280601 '
~ ,. ;
HARRISBURG PA 17128-0601
_ .. ,.~
REV-1543 Ex AGP-(0e•Ae).~
FILE N0. 21 --'~(7 j-~~~.2~
ACN 09155549
DATE 09-04-2009
~~~~ ~t~,j - ~ ~'{~ f ~~ ~~ EST. OF THELMA A YOHN
SSN 199-03-7604
~•,~ ,T~;i ~-;,r- DATE OF DEATH 07-04-2009
~ ~ ` CUMBERLAND
~--, ~ ;c r'~ ~:,T COUNTY
0,- , ~ L ., 1, , ;n
M1,, ,•, f"~ REMIT PAYMENT AND FORMS T0:
"`'~ ~ f REGISTER OF WILLS
RUTH D BARCKLEY CUMBERLAND CO COURT HOUSE
41 LENWOOD PARK PA 17257 CARLISLE, PA 17013
SHIPPENSBURG
TYPE OF ACCOUNT
SAVINGS
® CHECKING
TRUST
CERTIF.
provided the Department with the information below, which has been used in calculating the
potential tax due. Recordn indicate that at the death of the above named decedent, you were a .joint owner/beneficiary of t 1s acco
M & T BANK
is incorrect, please obtain written correction from the financial institution, attach a copy to this form
- dance with the Inheritance Tax laws of the Commonwealth of
If you feel the informatlo
and return it to the above address. This account 1s taxable 1n actor
Pennsylvania. Please call (717) 787-8327 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTION
Date 05-04-184 To ensure proper credit to the account, two
Account No. 61210897 copies of this notice must accompany
Established payment to the Register of Wills. Make check
2,941.82 payable to "Register of Wills, Agent".
Account Balance X 50.000
NOTE: If tax payments are made within three
Percent Taxable 1,470.91 months of the decedent's date of death,
Amount Subject t0 TaX ,~ 15 deduct a 5 Percent discount on the tax due.
X Anv Inheritance Tax due will become delinquent
TaX Rate 220.64 nine months after the date of death.
Potential Tax Due
TAXPAYER RESPONSE
PART
FAILU{tE 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 twoandpreturn this notice to theaRegister of
a discount or avoid interest, or check box "A"
fficial assessment will be issued by the PA Department of Revenue.
CHECK Wills and an o
d and tax paid with the Pennsylvania Inheritanc
t
e Tax re urn
e
ONE
B L 0 C K B. ~ The above asset has been or will be repor
estate representative.
C
0 N L Y to be filed by the
d deductions were paid.
C, 'The above information is incorre3t below. debts an
te PART 2~ and/or PART
l
e
Comp
OFFICIAL tFSE ONLY. ~ AAF
If indicating a different tax ~ate~(P~ ease state PA DEPARTMENT OF REVENUE
PART
relationship to decedent:
COMPUTATION OF TAX ON JOINT RUST ACCOUNTS PAD1
TAX RETURN -
-'~ ~ mac. 7 ~ ,' ~
1
LINE 1. Date Established $ ~`~`r!. ~,.-~ 2
I
2 3
2. Account Balance X S~~ ,s~'3 ~ 1
3 I 4
3, Percent Taxable $ `~, ~G7 fry /
[
~' ~
4. Amount Subject to Tax 4 '` ~~,
5. Debts and Deductions 5 $ rry 1 y
Y
iA 9
6
6. Amount Taxable X 4 1 "7 7
7 8
7. Tax Rate $ A~~,-~ ~IJ' _
8~_.
g. Tax Due
DEBTS AND DEDUCTIONS CLAIMED
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PART / ~ ~~(. S L =i- ~' r1~f 1
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AMOUNT PAID
.
DESCRIPTION
/
PAYEE
DATE FAID UPS ~ "~
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above are true, correct and
ed
facts I have
I declare thab
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ies of per
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