HomeMy WebLinkAbout10-16-09COMMON'S/EALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU CF INDIVIDUAL TAXES
DEPT. 286601
HARRISBURG, PA 1 7 1 28-0601
RECEIVED F=ROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 01 1868
HINKILE E L
97 LE:E ANN COURT
ENOL.A, PA 17025
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ESTATE INFORMATION: SSN: 201-78-3164
FILE NUMBER: 2109-0290
DECEDENT NAME: RAFFENSPERGER SARA J
DATE OF PAYMENT: 1 O/ 1 9/2009
POSTMARK DATE: 10/16/2009
COUNTY: CUMBERLAND
DATE OF DEATH: 03/ 1 9/2009
REMARh:S:
CHECK#1473
SEAL
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
09137918 ~ 551.78
TOTAL AMOUNT PAID:
INITIALS: CJ
REV-1162 EX111-96~
551.78
RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
BUREAU OF INDIVIDUAL TAXES AND FILE N0. 21 09-0290
Po Box zsocol ~ TAXPAYER RESPONSE ACN o913791s
HARRISBURG PA 17128-0601
'' - _~.. DATE 06-19-2009
REV-1543 E% AFP (OB-OB)
?^" -" `• ~ ~ i,-,. TYPE OF ACCOUNT
~O EST. OF SARA RAFFENSPERGER ~ SAVINGS
~ SSN 201-18-3164 ® CHECKING
- - DATE OF DEATH 03-19-2009 ~ TRUST
-~~~~=
` COUNTY CUMBERLAND ~ CERTIF.
!1 ~•.
r
J
~'~- ~ ~ REMIT PAYMENT AND FORMS T0:
ELIZABETH L HINKLE REGISTER OF WILLS
!~7 LEE ANN COURT CUMBERLAND CO COURT HOUSE
ENOLA PA 17025 CARLISLE, PA 17013
M 8. T 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 feed 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 I1I71 787-83[7 with questions.
COMIPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 70190402 Date 12-05-2002 To ensure aroaer credit to the account, two
Established copies of this notice must accompany
Account Balance 2, 301 .45 Payment to the Register of Wills. Make check
payable to "Register of Wills, Agent".
Percent Taxable X 50.000
NOTE: If tax payments are made within three
A IIIOUnt Subject to TaX $ 1,150.73 months of the decedent's date of death,
Tax Rate X .045 deduct a 5 percent discount on the tax due.
Any Inheritance Tax due will become delinquent
Potential Tax Due $` 51 • 78 nine months after the date of death.
PART TAXPAYER RESPONSE
FAILURE TO RESPOND W ILL 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.
C ONE:
B L 0 C:K B. ~ The above asset has been ar 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
TAX
If indicating a different tax rate, please state
relationship to decedent:
RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD
LINE 1. Date Established
2. Account Balance
3. Percent Taxable
4. Amount Subject to Tax
5. Debts and Deductions
6. Amount Taxable
7. Tax Rate
8. Tax Due
2 +~'
3 X
4
5
6 $
7 X
8 +fi
OFFICIAL USE ONLY ~ AAF
PA DEPA#2TMENT OF REVENUE
1
2
3
4
5
6
7
8
PART
DEBTS AND DEDUCTIONS CLAIMED
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
TOTAL CEnter on Line 5 of Tax Computation) S
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. ''c
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