HomeMy WebLinkAbout06-03-10COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 260601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
STRAW CHARLENE R
470 OLD STAGE ROAD
LEWISBERRY, PA 17339
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ACN
ASSESSMENT
CONTROL
NUMBER
fold
ESTATE INFORMATION: SSN: i7s-~6-6478
FILE NUMBER: 2110-0571
DECEDENT NAME: STRAW WAYNE
DATE OF PAYMENT: 06/03/2010
POSTMARK DATE: 06/03/2010
COUNTY: CUMBERLAND
DATE OF DEATH: 04/ 1 6/2010
REV-1162 EX111-96)
NO. CD 012847
AMOUNT
10127024 ~ 51, 801 .85
TOTAL AMOUNT PAID:
REMARKS:
SEAL
CHECK# 2744
INITIALS: CJ
RECEIVED BY:
51,801 .85
GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE _
AND FILE N0. 21 ~ ~ (,) `-j 7f
BUREAU OF INDIVIDUAL TAXES ACN 10127024 lI
PD eax zao6ol - T/K~C~AYER RESPONSE
HARRISBURG PA l~lzB-ocol _ DATE 05-17-2010
REV-1543 EX AFP CO b'_0$). - ' - - ~ -~
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** KERRY W STRAW
470 OLD STAGE RD
LEWISBERRY PA 17339
EST. OF WAYNE STRAW
SSN 178-16-6478
DATE OF DEATH 04-16-2010
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
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
?e,-„-, sd lvania. Pease nail i7;7~ 7Bi-8327 with questions.
rnMO~FTF PORT 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 7000171885
Account Balance
Date 11-16-2009
Established
$ 84,296.92
50 000
To ensure proper credit to the account, two
copies of this notice must accompany
payment to the Register of Wills. Make check
payable to "Register of Wills, Agent".
Percent Taxable X NOTE: If tax payments are made within three
Amount Subject to Tax ry{` 42, 148 • 46 months of the decedent's date of death,
0 4 5 deduct a 5 percent discount on the tax due.
TaX Rate X . Any Inheritance Tax due will become delinquent
Potential Tax Due ,~` 1 , 896.68 nine months after the date of death.
TAXPAYER RESPONSE
PART
FAILURE TO RESPOMD ssWILL RESULT IN AN OFFICIAL TAX,ASSESSMENT
~[ The above information and
A tax due is correct.
.
L^~. Remit payment to the Register of Wills with two copies of this notice to obtain
discount or avoid i nterest, or check box "A" and return this notice to the Register of
C H E C K a
Wills and an official assessment will be issued by the PA Department of Revenue.
ONE
BLOC K
C 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 representa tive.
~ The above information is incorrect and/or debts and deductions were paid.
C
.
Complete PA RT ~ and/or PART ~ below.
If indicating a different tax rate, please state OFFICIAL- USE ONLY ~ AAF-
PART t
d REVENUE
en
:
relationship to dece PA DEPARTMENT OF
TAX RE TURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD
LINE i. Date Established 1 ~ 1
2. Account Balance 2 $ 2
3. Percent Taxable 3 X 3
4. Amount Subject to Tax 4 $ ~ 4
5. Debts and Deductions 5 5
6. Amount Taxable 6 `~ G
7. Tax Rate 7 X 7 -
8
D '~ 8
8. ue
Tax
DEBTS AND DEDUCTIONS CLAIMED
PART
,..T ~ nwTn pevFF DESCRIPTION AMOUNT PAID
Under penalties of perjury, I declare that the facts I have reported above are true, correrct and
complete to the best of my knowledge and belief. HOME Cif! 7 ~ ~ 3 ~ ' Z` L~~
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