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HomeMy WebLinkAbout03-16-10COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: WITMER THOMAS E 2451 RITNER HIGHWAY CARLISLE, PA 17015 fold REV-1162 EX111-96) PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ESTATE INFORMATION: ssnl: 1sa-2s-5304 FILE NUMBER: 2110-0243 DECEDENT NAME: WITMER HELEN M DATE OF PAYMENT: 03/16/2010 POSTMARK DATE: 03/16/2010 COUNTY: CUMBERLAND DATE OF DEATH: 02/04/2010 ACN ASSESSMENT CONTROL NUMBER AMOUNT 10112495 ~ 5450.00 TOTAL AMOUNT PAID: REMARKS: CHECK#1495 SEAL INITIALS: DM 5450.00 RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS NO. CD 012477 REGISTER OF WILLS PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES AND FILE N0. 21 -10 ~ ~~'J Po Box 288601 1 TAXPAYER RESPONSE ACN 10112495 HARRISBURG PA 17128-0601 ~ ~ .-~~-~{ ~ (~~ ~_~~~#p`~ae~ F c' DATE 03-05-2010 ZOtQ t~dR t 6 PM t2: 55 ci~~f< ~F QRP~p~~',~ ~QtlRT THOMAS E WITMER 2451 RITNER HWY CARLISLE PA 17015 EST. OF HELEN M WITMER SSN 168-26-5304 DATE OF DEATH 02-04-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. ORRSTOWN 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 Feint 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 fora and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Commonweolth of Pennsylvania. Please call (717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 4000024079 Date 03-14-2008 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance $ 20 000 00 payment to the Register of Wills. Make check " " . , payable to Register of Wills, Agent . Percent Taxable x 50.000 Amount Subject to Tax ~ 10 000 00 NOTE: If tax payments era made within three . , months of the decedent's date of death, Tax Rate x , 15 deduct a 5 percent discount on the tax due. Potential Tax Due ~ 1,500.00 Any Inheritance Tax due will become delinquent 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 bean 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 informs ion is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART 3~ below. PART If indicating a different tax rate, please state relationship to decedent: °, TAX RETURN - COMPUTATION 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 PART DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported above are true, correct and complete to the st f y knowledge and belief. HOME ~7~7) ~-y9 790 WORK C ) TAXPAYER S GNATURE TELEPHONE NUMBER DATE OF TAX ON JOINT/TRUST ACCOUNTS ~~~;', 1 "~ - ~ _. 3 x J U%© ~ ,, 4~i S lD,noO. D0 , _,. ', 5' _ ~ 6 $ ~ ~ . ~' 7 x by ~ g $ ~~~0 DEBTS AND DEDUCTIONS CLAIMED TOTAL CEnter on Line 5 of Tax Computation) ~