HomeMy WebLinkAbout06-09-10COMMONWEALTH 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 EX(11-96)
NO. CD 012879
KELLY RUTH
691 MAGARO RD
ENOLA, PA 17025
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DUPLICATE
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
ESTATE INFORMATION: SSN: 162-52-1930
FILE NUMBER: 2110-0594
DECEDENT NAME: KELLY CHARLOTTE
DATE OF PAYMENT: 06/09/2010
POSTMARK DATE: 06/06/2010
COUNTY: CUMBERLAND
DATE OF DEATH: 08/04/2005
REMARKS:
CHECK# 61 14
10100932 ~ $92.03
TOTAL AMOUNT PAID: $92.03
INITIALS: DM
SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
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BUREAU OF INDIVIDUAL TAXE9',~~~`f ' ~ '' '
PO BOX 280601
HARRISBURG PA 17128-0601. • , ',~~ a"
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PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
AND FILE
TAXPAYER RESPONSE ACN
DATE
N0. 21 ~-~(S - ~~~
10100932
01-08-2010
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RUTH E KELLY
691 MAGARO RD
ENOLA PA 17025-1936
EST. OF CHARLOTTE KELLY
SSN 162-52-1930
DATE OF DEATH 08-04-2005
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
TYPE OF ACCOUNT
SAVINGS
® CHECKING
TRUST
CERTIF.
PN C BANK NA 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. Pease call C717) 787-8327 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 000005140033704 Date 06-01-1982
To ensure proper credit to the account, two
Established copies of this notice must accompany
Account Balance $ 1 , 227.0 0 payment to the Register of Wills. Make check
payable to "Register of Wills, Agent".
Percent Taxable X 50.000
Amount Subject to Tax $ 613.50 NOTE: If tax payments are made within three
months of the decedent's date of death,
Tax Rate X ~ lij deduct a 5 percent discount on the tax due.
Potential Tax Due $ 92.03 Any Inheritance Tax due will become delinquent
nine months after the date of death.
PART TAXPAYER RESPONSE
1 .•b .. . c . ... r m ....... . .. ...
A. ~ The above information and tax due is correct.
Remit 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
0 N E 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
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 2~ and/or PART 3~ below.
PART If indicating a different tax rate, please state '~~t`• .~':~"
2 relationship to decedent: f ,.
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 $
;o`~f '
5. Debts and Deductions 5 - ~~%` '~
6. Amount Taxable 6 ~~~
7. Tax Rate 7 X y
8. Tax Due 8 $ y
PART
0
DATE PAID PAYEE
DEBTS AND DEDUCTIONS CLAIMED
DESCRIPTT[]N
wun~~ur n. TT
Under penalties of perjury, I declare that the facts I have reported abo~v-fie are true, correct and
complete to th best of my knowledge and belief. HOME C~~,1 ) ~~j~'
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WORK C ) - ~1'-T-
TAXPAYER SIG ATUR TELEPHONE NUMB R DATE