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HomeMy WebLinkAbout04-06-10REV-1162 EX(11-96) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: WILLIARD SUSAN E 501 COUNTRY CLUB ROAD CAMP HILL, PA 1701 1 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ACN ASSESSMENT CONTROL NUMBER fold ESTATE INFORMATION: FILE NUMBER: DECEDENT NAME: DATE OF PAYMENT: POSTMARK DATE: COUNTY: DATE OF DEATH: SSN: 196-14-0961 2110-0171 URBAN CHARLOTTE 04/06/2010 04/05/2010 CUMBERLAND 01/03/1925 TOTAL AMOUNT PAID: REMARKS: CHECK#1923 SEAL INITIALS: CJ RECEIVED BY: NO. CD 012577 AMOUNT 5167.11 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS PENNSYLVANIA INHERITANCE TAX .I,NFORMATION NOTICE - AND FILE N0. 21 10-0171 BUREAU OF INDIVIDUAL TAXES /RCN 10116467 Po Box zao6ol TAXPAYER RESPONSE HARRISBURG PA lnzB-o6o1 - -' DATE 03-18-2010 REV-1543 E% AFP (OB-OB) -.;,,n TYPE OF ACCOUNT SAVINGS ® CHECKING TRUST CERTIF. J EST. OF CHARLOTTE URBAN ~' "`'- 196-14-0961 C~E~ ;~. ~.;r ssN aRP}7r.~' ~ ';(;!r14~T DATE OF DEATH 12 -14 - 2 0 0 9 C11~'~'~~' . "'_ ` _~ ply. COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: SUSAN E WILLIARD REGISTER OF WILLS 501 COUNTRY CLUB RD 1 COURTHOUSE SQUARE CAMP HILL PA 17011 CARLISLE PA 17013 METRO 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 feel the information is incorrect, please obtain written correction from the financial institution, attach a copy to this form znd roture it to the above address. This wrcnunt i< tax abl? in ar_ro rdanra with the Inheritance Tax laW~ 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. 538200098 Date 08-25-2008 7o ensure proper credit to the account, two Established copies of this notice must accompany payment to the Register of Wills. Make check Account Balance $ 132 • 10 payable to "Register of Wills, Agent". NOTE: If tax payments are made within three Percent Taxable X 50.000 Amount Subject to Tax $ 66.05 months of the decedent's date of death, X 1 5 deduct a 5 percent discount on the tax due. Tax Rate Anv Inheritance Tax due will become delinquent Potential Tax Due $ 9 • 91 nine months after the date of death. P~T TAXPAYER RESPONSE ~ AILURE TO RESPOND WILL RESULT IH AN IFFICIAL TAX A55E5SMEHT A. ~ The above information and tax due is correct. t to the Register of Wills with two copies of this notice to obtain Remit paymen discount or avoid interest, or check box "A" and return this notice to the Register of CHECK a 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 or will be reported and tax paid with the Pennsylvania Inheritance Tax return . 0 N L Y to be filed by the estate representative. The above information is incorrect and/or debts and deductions were paid. C. Complete PART 2~ and/or PART ~ below. If indicating a different tax ate, please state OFFICIAL U5E ONLY Q AAF ' ~ PART relationship to .P/t~ n~~ rah ~ decedent: ~~J PA DEPARTMENT OF REVENUE TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD _____ _ _ ___, _. _. _. _____ __ _: 1 LINE 1. Date Established 1 ~ 2 ,~ 2. Account Balance $ / Z ~ 3 3. Percent Taxable X ~ 3 4 4. Amount Subject t $ ~ ~D , d o Tax 4 5 5. Debts and Deductions 5 6 6. Amount Taxable 6 7 7. Tax Rate X r 7 n 8 8. Tax Due $ ' 8 r~C DEBTS AND DEDUCTIONS CLAIMED PART DESCRIPTION AMOUNT PAID DATE PAID PAYEE TOTAL CEnter on Line 5 of Tax Computation) $ Un er nalties of perjury, I declare that the facts I have reported abov2e are true, corm` ary~1 lief b C ~ com to to the e . HOME 7 t ~f y o++ledge and ~~ // ~ ~ ~ ~ WORK ~ ~ ~ ~ ~~, DATE / / ~ - ~/ TFi FPHONE NUMBER BUREAU OF INDIVIDUAL TAXES PO BOX 28D601 HARRISBURG PA 17128-0601 REV-1543 EX AFP"I OB-OB) PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE -,~;. (',.= AND FILE N0. 21 10-0171 ' - TAXPAYER RESPONSE ACN 10116468 ~.,. DATE 03-18-2010 ~L~t~ ~~~ ~O ~~~ ~; ~~J ~F ' ~~~~' t,~.i~~~n CUB >:'.. , . _ . EST. OF CHARLOTTE URBAN SSN 196-14-0961 DATE OF DEATH 12-14-2009 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: SUSAN E WILLIARD REGISTER OF WILLS 501 COUNTRY CLUB RD 1 COURTHOUSE SQUARE CAMP HILL PA 17011 CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS ® CHECKING TRUST CERTIF. METRO 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 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 (717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 536041197 Date 05-13-2002 To ensure Proper credit to the account, two Established copies of this notice must accompany payment to the Register of Wills. Make check Account Balance $ 7 , 295.26 payable to "Register of Wills, Agent". Percent Taxable X 50'000 NOTE: If tax payments are made within three Amount Subject to Tax $ 3, 647.63 months of the decedent's date of death, X 1 5 deduct a 5 percent discount on the tax due. Tax Rate Anv Inheritance Tax due will become delinquent Potential Tax Due $ 547.14 nine months after the date of death. PART TAXPAYER RESPONSE ~ FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSE5SMENT A. ~ The above information and tax due is correct. Remit payment 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 CHECK Wills and an official assessment will be issued by the PA Department of Revenue. B L 0 C K B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return C ONE 0 N L Y to be filed by the estate representative. C. IXI The above informs tan is incorrect and/or debts and deductions were paid. Yl Complete PART 2~ and/or PART 3~ below. If indicating a different tax rate, please state OfiFICIA~L USE Ofi1LY ~ AAF PART relationship to decedent: PA DEPARTMENT OF REVENUE _ __... TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD ___ __ LINE 1. Date Established 1 2 2. Account Balance 2 $ 7295. ~~n - X K~D . D © 3 3. Percent Taxable 3 4. Amount Subject to Tax 4 $ 3~H`~- ~^~ 5 5. Debts and Deductions 5 $ 6 6. Amount Taxable 6 X .0 7 7. Tax Rate $ 8. Tax Due 8 $ /~~` l~ DEBTS AND DEDUCTIONS CLAIMED PART DESCRIPTION AMOUNT PAID DATE PAID PAYEE TOTAL (Enter on Line 5 of Tax Computation) $ Und r nalties of perjury, I declare that the facts I have reported above_/are true, correct and HOME C Y ~ /~~ ~^'~~~ comp to to the be j of n w dge/a/nod belief - WORK C~~ ~ ~j ~ ~~~ ~~ ~ ~~~~~ ~l" TFI EPHONE NUMBER DATE -~ -~. :~~ ~. ~~;., - ~,,.,: :- ~^F ~.9 '. ~i!r Ii. ~1:.' :R, '"t t:s,: VI 0 f,' ~ ; ~ h` ; ~ ~ ~ U r~ ~ ~' = C ~ r '. i. r ' - Q ~ ~ 1J I~ . ~ ~ U NF _ '~ E ~ ~~ ~ ~ ~ (Q =~UOU 1 } ad r l~~-'~~ ,; ~~,~dF{d~0 -~ z ~ ~- L ., ~°nU iYi },~ ~~s .~:. s'' ~ .,:E ~:::~ ,•.. .~..,