HomeMy WebLinkAbout04-01-10COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280801
HARRISBURG, PA 17128-0601
RECEIVED FROM:
TESLAR STEPHANI
412 N BEAVER STR ET
FLAGSTAFF, AZ 8 001
fold
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1162 EX111-961
NO. CD 012554
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
10104439 ~ 51,599.55
ESTATE INFORMATION: ' ssN: 1sa-ss-aasl
FILE NUMBER: 2 109-0838
DECEDENT NAME: ESLAR STEPHEN D
DATE OF PAYMENT: 0 4/01/2010
POSTMARK DATE: 3/29/2010
COUNTY: C UMBERLAND
DATE OF DEATH: 4 8/27/2009
REMARKS: STEPHAN~E TESLAR
SEAL
CHECK# 216
TOTAL AMOUNT PAID:
INITIALS: WZ
RECEIVED BY:
51,599.55
GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
USA FIF3T'LLA55 F00.E-EM1
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PENNSYLVANIA INHERITANCE T
INFORMATION NOTICE
~,,.~
BUREAU OF INDIVIDUAL TAXES r 1 ~!~M--r aN
PO BOX 280601 ~gn'~fy1s~R RESPONSE
HARRISBURG PA 17128-0601 ~
iv ,, ~-_., - ,.
FILE N0. 21 09-0838
ACN 10104439
DATE 01-21-2010
zoo aPR - i ~~ ~o•
eavasas a Avr coe-ou "- -
•`£ST. OF STEPHEN D TESLAR
CLERK{jF SSN 193-36-4451
//++ ORP~a~~'S ~OE~RT COIINTYF DEATCUMBERLAND009
l~~f~'~~~'~1~ ~r~it} ,~.r
`t' '~'~~ , PA, REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
5 CARLISLE PA 17013
TYPE OF ACCOUNT
SAVINGS
CHECKING
® TRUST
CERTIF.
STEPHANIE N TE~SLAR
300 ADAMS RD ',
CARLISLE ' PA 1701
BANK OF AMERICA NA
Dotential tax due. Records ino
If you feel the inforoation is
and return it to the above addr
Pennsylvania. Please call C717
COMPLETE PART 1 B
provided the Department with the inforoation below, which has bean used in ealculatin9 the
:ate that at she death of the above-named decedent, you were a joint owner/beneficiary of this account.
:correct. D1'ase obtain written correction from the financial institution. attach a copy to this fore
.s. This account is taxable in accordance with the Inheritance Tax laws of the Commonwealth of
787-Bb27 with questions.
LOW ^ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 910000 249 5590 Date 03-12-2008
To ensure Drover credit to the account, two
Established copies of this notice must accomparo
Account Balance $ 10
663
66 Pavwnt to the Resister of Wills. Make check
,
. Dayable tq "Resister of Wills, Asent".
Percent Taxable X 100.00
Amount Subloet to TaX
10
663
66 NOTE: If tax payments era made within throe
.
, months of the decedent's data of death,
Tax Rate ~( 15 deduct a 5 percent diswunt on the tax due.
POtentlal Tax Due 1
599
55 Any inheritance Tax due will become delinquent
,
. nine months after the date of death.
A. ~ ~he above inforoation and tax due is correct.
~, Resit payment to the Resister of Wills with Mo copies of this notice to obtain
CHECK a discount or avoid interest, or check box "A" and return this notice to the Resister of
ONE
~ Wills and an official assessment will be issued by the PA Department of Revenue.
BLOCK B. ~ ~he above asset has boon ar will be reported end tax paid with the Pennsylvania Inheritance Tax return
ON L Y o be filed by the estate representative.
C. ~ The above informs ion is incorrect and/or debts and deductions ware paid.
~omDlete PART 2~ and/or PART 3^ below.
PART If lndicatinD a d fforont tax rate, please state
relationshlp to d cadent:
TAX RETURN - COMPUTA'~ION OF TAX ON JDINT/TRUST ACCOUNTS
LINE 1. Dato Establish d '~, 1
2. Account Balance 2 ~
3. Parcont Taxable 3 X
4. Amount Subloct toTax 4 ~
5. Debts and Deductions 5
6. Amount Taxable ', 6 $
7. Tax Rato '', 7 X
8. Tax Due ' e ~`
PART ', DEBTS AND DEDUCTIONS CLAIMED
DATE PAID FPAYEE DESCRIPTION AMOUNT PAID
TOTAL CEnter on Line 5 of Tax Computation) •
Under penalties of par~
complote to the best o i ury, I declare that the facts I have reported above aro true, correct and
f my knowledge and bolief. HOME C )
WORK C )
TAXPAYER SIGNATURE TELEPHONE NUMBER DATE
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