HomeMy WebLinkAbout04-23-10COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128.0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1162 EXI11-96)
NO. CD 012655
DECKER LINDA A
204 RIDGEVIEW RD
NEW CUMBERLAND, PA 17070
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ESTATE INFORMATION:
SSN: 201-18-2262
FILE NUMBER: 2110-0435
DECEDENT NAME: DECKER CARMELLA M
DATE OF PAYMENT: 04/26/2010
POSTMARK DATE: 04/23/2010
couNTY: CUMBERLAND
DATE OF DEATH: 02/2$/2010
REMARKS:
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
TOTAL AMOUNT PAID:
5111.79
CHECK#1233
INITIALS: SAP
SEAL
RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
USA FIRST-f LASS FOREVER ~'.
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PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
BUREAU OF INDIVIDUAL TAXES AND F I L E
PO BOX 280601
WIRRISBURG PA 17128-0601 '`~~ ,~t ~ :., ~";,`' TAXPAYER RESPONSE ACN
xev4w~i-cx=~ ioq;.opS 'i'+ DATE
X0(0 APR 26 Pty i ~ 04
Cf ERK ~~
Q+~!'t-'~° '~ ' '?URA
:
t ,~~ t i-
U,,,~, .., ':0., PA
LINDA A DECKER
204 RIDGEVIEW RD
NEW CUMBERLAND PA 17070
EST. OF CARMELLA M DECKER
SSN 201-18-2262
DATE OF DEATH 02-28-2010
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
No. 21-~p--o~l3s'
10120119
04-07-2010
TYPE OF ACCOUNT
SAVINGS
® CHECKING
TRUST
CERTIF.
SUSQUEHANNA 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 th
b
e a
ove-named decedent,
If you feel the information is incorrect, please obtain written correction from the
and return it to the abo
dd you were a point owner/beneficiary of this account.
financial institution
tt
ve a
ress. This aecaunt is taxable in accordance with the
Pennsylvania. Please call C717) 787-8327 with questi , a
ach a copy to this form
Inheritance Tax laws of the Conwonwealth of
ons.
COMPLETE PART 1 BELOW ~ SEE REVERSE SIDE FOR FILING
AND PAYMENT INSTRUCTIONS
Account No. 5400192009 Date 09-20-1995
Established To ensure proper credit to the account, two
Account Balance copies of this notice must accompany
$ 14,904.74 payment to the Register of Wills. Make check
Percent Taxable X
16.667 payable to "Register of Wills, Agent".
Amount Subject to Tax $ 2, 484.17 NOTE: If tax payments are made within three
TaX Rate
X months of the decedent's date of death,
. 0 4 5
Potential Tax DU deduct a 5 percent discount on the tax due.
e $ 111 .79 Any Inheritance lax due will bacons delinquent
P
T nine months after the date of death.
a
TAXPAYER RESPONSE
A. The above information and tax due is correct.
Resit 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.
B L 0 C K B. ~ Tha 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.
C. ~ The above informs ion is incorrect and/or debts and deductions were paid.
- Complete PART ~ 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 $
3. Percent Taxable 3 X
4. Amount Subject to Tax 4 $
5. Debts and Deductions 5 -
6. Amount Taxable 6 $
7. Tax Rate ~ X
8. Tax Due B $
PART DEBTS AND DEDUCTIONS CLAIMED
0
DATE PAID PAYEE DESCRIPTION
AMOUNT PAID
TOTAL (Enter on Line 5 of Tax Computation) g
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
mplete to the best of my knowledge and belief.
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TAXPAYER SIGNATURE WORK ( ) ~ /~
TELEPHONE NUMBER ATE