HomeMy WebLinkAbout03-02-10COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
REV-1162 EXI11-96)
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
N0. CD 012410
REAM JEAN E
1 145 PHEASANT DRIVE N
CARLISLE, PA 17013
fold
ESTATE INFORMATION: ssrv: 175-io-~4oa
FILE NUMBER: 2109-1 175
DECEDENT NAME: KELLER INA M
DATE OF PAYMENT: 03/02/2010
POSTMARK DATE: 03/01 /2010
couNTY: CUMBERLAND
DATE OF DEATH: 12/09/2009
REMARKS:
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
10103407 ~ 51, 517.07
TOTAL AMOUNT PAID:
51,517.07
CHECK#1659
INITIALS: DM
SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF INDIVIDUAL TAXES
PO BOX 2806D1
HARRISBURG PA 17128-0601
PENNSYLVANIA INHERITANCE T
INFORMATION NOTICE
AND
l"~~;~ (~~ TAXPAYER RESPONSE
,..~..
FILE N0. 21 09-1175
ACN 10103407
DATE 01-18-2010
2018 MAR -~ PM 12~ 5S~
~yoy~f~ °~,~~y
tIVMR~lI~~.~'~~ F1~1
JEAN REAM- "~~'
1 I ~ 5 ~ HeasGt~ 1J r. N ~`
Carlisle ~~ I-1013
EST. OF INA M KELLER
SSN 175-10-7404
DATE OF DEATH 12-09-2009_
COUNTY. CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
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 point owner/beneficiary of this account.
If you feel the information is incorrect, please obtain written correction frow 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 Cosmonwealth of
Pennsylvania. Please call C717) 787-@327 with questions.
COMPLETE PART I BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 000031800163927 Date 09-02-1999
Established
Account Balance
Percent Taxable
Amount Subject to Tax
Tax Rate
$ 10,646.16
X 100.00
$ 10,646.16
X .15
To ensure proper credit to the account, two
copies of this notice must accompany
payment to the Register of Wills. Make check
payable to "Register of Wills, Agent".
NOTE: If tax payments are made within thre~
months o the ece an 's da e o ea ,
deduct a 5 percent discount on the tax due.
Any Inheritance Tax due will become delinquent
Potential Tax Due $ 1 , 596.92 nine months after the date of death. D~r' I S I7.
PART
a
CHECK
ONE
[ BLOCK
ONLY
TAXPAYER RESPONSE
A. ~ The above information and tax due is correct.
Remit Dayment to the Register of Wills with two copies of this notice to obtain
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 Revenua.
~~1bsq
B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
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
relationship to decedent:
TAX RETURN - COMPUTATION OF TAX ON .JOINT/TRUST ACCOUNTS
LINE 1. Date Established 1
2.
Account Balance 2 k ;
`, ''}''°~° 4 ''"~'~ ~'~'~''~gp~~a,re
»~. -
3.
Percent Taxable 3
X
~, ~,
t ~fi„, i ~ ~~~ r ~> ~z~~~' ~i~
'~ ,~.ww.»
4.
Amount Subject to Tax 4 1~ j~V ~ t3 ~y7i,
5. Debts and Deductions 5 - ~, '~~ ~»
6.
Amount Taxable 6 ~» .
>.
7.
Tax Rate 7 X ~ ..
.~ s v'""
8. Tax Due 8
PART DEBTS AND DEDUCTIONS CLAIMED
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
Under penalties of perjury, I declare that the facts I have reported abov
e are true, correct and
of my knowledge and belief.
c
om
p let
e to
th
e
b
est -
T
HOME C ~ 1 )
(~ ,
n
-
'
~
,,
~
~
)
\~4~X1/N/ ~'~UiY~+~ WORK ( ) N fF o~ .'~17 / D
+':; d~
8~ ~; ~
~ ~„
~. ~'"
2010 l9AR -2 Pl112= 5
J ~ ~
I~ vR~
O .y h
1
~.
N-
..t
'~y
P~•
tt~
~.
~+
`tip
~ ~~
~.. o y
w ~~ ~~
~"' ~ ~ ~~~ 1~ ~~
~ ~~
_ ~` ~~
i~
j ~'~,: ~'
~~ ~F g
j{{ ,~i$e
_ ,{a'S
. r `~.