HomeMy WebLinkAbout11-25-09COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
SAYLOR SHARON E
22 CREEK BANK DR
MECHANICSBURG, PA 1 7050-1 81 4
,old
ESTATE INFORMATION: sSN: 210-12-4660
FILE NUMBER: 2109-1 104
DECEDENT NAME: SAYLOR DONALD S
DATE OF PAYMENT: 1 1 /25/2009
POSTMARK DATE: 1 1 /24/2009
COUNTY: CUMBERLAND
DATE OF DEATH: 10/13/2009
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
09173427 ~ 5432.47
TOTAL AMOUNT PAID:
REMARKS:
CHECK# 9016
SEAL
INITIALS: JN
RECEIVED BY:
5432.47
GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REV-1162 EX(11-96)
NO. CD 012036
REGISTER OF WILLS
BUREAU OF INDIVIDUAL TAXES
PO BOX 280601
HARRISBURG PA 17128-0601
REY-1543 IX AFP (0~
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
AND FILE N0. 21 COQ IIU~k
~r[ ! ,^~"~jA~lC~,~YER RESPONSE ACN 09173427
r ,
al,r DATE 11-16-2009
Z4fl9N01~ 25 FM 2' SOEST. OF DONALD S SAYLOR
SSN 210-12-4660
~~~~~ ~ DATE OF DEATH 10-13-2009
~~~~5 ~DU~ COUNTY CUMBERLAND
t ~,-~' n h, (~('~ RA REMIT PAYMENT AND FORMS T0:
SHARON E SAYLOR ~'~~'"~`- ~ '~ J~ t1 REGISTER OF WILLS
22 CREEK BANK DR CUMBERLAND CO COURT HOUSE
MECHANICSBURG PA 17050-1814 CARLISLE, PA 17013
TYPE OF ACCOUNT
SAVINGS
® CHECKING
TRUST
CERTIF.
PNC BANK NA 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. Please call C717) 787-8327 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 00000514 0240789 Date 12-1 3-2002 7o ensure proper credit to the account, two
Established copies of this notice must accompany
Payrent to the Register of Wills. Make check
Account Balance 19, 221 .09 Dayable to "Register of Wills, Agent".
Percent Taxable X 50 .000
NOTE: If tax payments are ^ade within three
Amount Subject to Tax $ 9, 610 .55 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 $ 432 .47 nine months after the date of death.
P
RT TAXPAYER RESPONSE
A
A. ~ The above information and tax due is correct.
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
ON 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 ~ below.
PART If indicating a different tax rate, please state P~tF`1 - ~
relationship to decedent:
~A'
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS D i
LINE
1 .
Date Established 1 ,r .,. ~,
~,,,«,M„,w~ ~ {'~ ~~' ~~ `~~` x ~ iu `;~~~ xz~
2. Account Balance 2 ~ s' ~~' '
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3. Percent Taxable 3 X
~ .. ,
~ i
4. Amount Subject to Tax 4 ~ » '~ ~"` '~"
,~
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5. Debts and Deductions 5 - .
', $ » ~'"~
6. Amount Taxable 6 ~
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~' (
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7. Tax Rate 7 X f~ B. ~13~
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8. Tax Due 8 .~....-, !w»
PART DEBTS AND DEDUCTIONS CLAIMED
a
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
TOTAL CEnter on Line 5 of Tax Computation) 6
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 )
WORK C )
TAXPAYER SIGNATURE TELEPHONE NUMBER DATE