HomeMy WebLinkAbout05-03-10 (2)COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1 7128-0601
RECEIVED FROM:
REV-1162 EX(11-96)
PENNSYLVANIA
INHERITANCE AND ESTATE -f AX
OFFICIAL RECEIPT
NO. CC) 012687
KEPPLE MARY R
2566 COON CLUB RD
WESTMINSTER, MD 21157-6610
---'---- fold
ESTATE INFORMATION:
SSN:
FILE NUMBER: 21 10-0459
DECEDENT NAME: LUPP MARY L
DATE OF PAYMENT: 05/03/2010
POSTMARK DATE: 04/30/2010
COUNTY: CUMBERLAND
DATE OF DEATH: 10/07/2009
REMARKS:
CHECK#1155
SEAL
166-12-0197
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
51,035.74
TOTAL AMOUNT PAID:
INITIALS: SAP
RECEIVED BY:
REGISTER OF WILLS
GLENDA EARNER STRASBAUGH
REGiISTER OF 1NILLS
PENNSYLVANIA INHERITANCE: TAX
INFORMATION NOTICE
BUREAU OF INDIVIDUAL TAXES
PD Bax z8o6o1 - ~~~- -~ ~•_ AND
HARRISBURG PA 17128-0601
,~, ~'AXPAYER RESPONSE
REV-1543 EXAFP~(08-08)~' •l ~ `
~r~0~ P~~~Y -3 P~! i~'~ Q6~
FILE INO. 21 /(~_tti,~J~-J~~
ACN 10117188
DATE 03-23-2010
EST. OF MARY L KUPP
C~"'1, ~,~- SSN 166-12-0197
~r~~.`._.~s:~~ ~~ ;,y :~ +~~~ DATE OF DEATH 10-07-2009
~ ?'. ~- - ~ ~,~ COUNTY CUMBERLAND
MARY R KEPPLE ~ REMIT PAYMENT AND FOI~MS T0:
2566 COON CLUB RD REGISTI_R OF WILLS
WESTMINSTER MD 21157-6610 1 COURi~HOUSE SQUARE
CARLISLE PA 17013
TYPE OF ACCOUNT
® SAVINGS
CHECKING
TRUST
CERTIF.
PNC BANK NA
potential tax due. provided the Department with the information below, which has been used in calculatin t
Records indicate that at the death of the above-named decedent
If you feel the information is incorrect, please obtain written correction from the financi
and return it to the above address. ~ you were a joint owner/beneficiary of this ac ount.
Pennsylvania. Please call (717) 787-g3z7 with al institution, attach a copy to this form
This account is taxable in accordance with the Inheritance Tax :laws of the Commonwealth of
COMPLETE PART 1 BELOW * questions.
SEE REVERSE SIDE FOR FILING AND PAVM~u•r T.~~~...._
ACCOUnt Nn nnnn.,.-~___
Account Balance
Percent Taxable
Amount Subject to Tax
Tax Rate
Potential Tax Due
PART
u
CHECK
ONE
BLOCK
ONL Y
.. ., ..uu~~~ylUt3461 Date
Established
10-09-2008
$ 46,032.75
X 50.000
$ 23,016.38-.
X .045
$ 1,035.74
TAXPAYER RESPONSE
-- ~••~ ~ rtut, 1 11JN5
To ensure proper credit to the account, two
copies of this notice must accompany
payment to the Register of Wills. Make check
payable to "R,gister of Wills, Agent".
NOTE: If tax payments are made within three
months of the decedent's date of death,
deduct a 5 percent discount on the tax due.
Any Inheritance Tax due will become delinquent
nine months after the date of death.
Kemit payment to the Register of Willscwith two copies of this noti~_ '--
e to obtain
Willscandtanrofficialnassessment willkbeoissuedabd reaturn this notice to the Register of
y the PA Department: of Revenue.
B• ~ The above asset has been or will be reported and tax
to be filed by the estate representative. paid with the Pennsylvania Inheritance Tax return
C• ~ The b
a ove information is incorrect and/or debts and deductions were
Complete PART ~ and/or PART
paid.
below
PART If indicating a different
relationshi tax rate
~ Please st
t .
p to decedent: a
e _~
TAX RE TURN
- COMPUTATION ---- ---- OF~~ICIAL l
LINE
1. OF
Date Established TAX ON JOINT/TRUST ACCOUNTS ~'~ DE1'ARTMEN
PAD
2• 1
Account Balance 2
$
1
3. Percent Taxable 3 X 2
4• Amount Subject to Tax q $ 3
5. Debts and Deductions 5 - ~
6• Amount Taxable 6 $ ~,
7• Tax Rate ~ X b
B. Tax Due 8 $ 7
PART 8
3~ DEBTS AND DEDUCTIONS CLAIMED ~--~"
DATE PAID PAYEE
DESCRIPTION
Under onn~,~:
TOTAL CEnter on Line 5 of Tax Comm„+-.+:__.
AMOUNT PAID
complete ---+.., V~ Wer~ury, I
to the best of my kn
TAXPAYER SIG TURE
declare ~~~~ $ --~
that the facts I have reported at~ove are true
~wledge and belief. correct and
~it ~ HOME ( i'~/L~ ~ ~ /
WORK ( ~ ~ -~ ~ ~'
TELEPHONE NUMBER `~.°*~
- DATE
- - _ ,.__,