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Home My WebLink About06-09-10BUREAU OF INDIVIDUAL TAXES PO BOX 280601 HARRISBURG PA 17128-0601 REV-1543 EX PENNSYLVA#lNHERITANCE TAX INFORMATION NOTICE AND FILE N0. 21-~o-b'Y5~ _ TAXPAYER RESPONSE ACN 10127967 ~' ~ _r, ,.~~.~~~~- "' DATE 05-19-2010 ~. _T08 ,OBJ . ~1 ,. , -~..JI t r ~ ~.'v 2Q 10 J~1N - 9 P~f 2~ Q 4 ~E~~ ~~ ~~ Ct~~~PH#i~~'S, ~ (~~~RT JOSHUA A ORRIS ~ , d,Y. ~,:.._,, ~~! 2579 RALEIGH RD HUMMELSTOWN PA 17036 EST. OF ANNA M ORRIS SSN 195-07-5626 DATE OF DEATH 01-23-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS ® CHECKING TRUST CERTIF. WACHOVIA BK 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. Please call (717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 10100812431 63 Date 06-0 3-2004 To ensure proper credit to the account, two Established copies of this notice must accompany Payment to the Register of Wills. Make check Account Balance 1 ~ 160 . $$ payable to "Register of Wills, Agent". Percent Taxable )( 50 .000 NOTE: If tax payments are made within three Amount Subject to Tax $ 580 . ~F~F months of the decedent's date of death, Tax Rate X . 15 deduct a 5 percent discount on the tax due. Any Inheritance Tax due will become delinquent Potential Tax Due $ 87 • 07 nine months after the date of death. PART TAXPAYER RESPONSE 1 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 Wills and an official assessment will be issued by the PA Department of Revenue. ONE BLOCK B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return ONLY to be filed by the estate representative. C. ~ The above information is incorrect and/or debts and deductions were paid. "~~" Complete PART 2~ and/or PART ~ below. k~.r::o: •: ;.: . Y..... :v:.: i ;c y t .:.r.:. , t## [ ... .fib If indicatin a different tax ra a lease state :..~:.....>y. P :~ ~ ., : 9 PART .dy e;. ~' F.: ~ `05 ff ~ :$r :..a ce relationshi to de dent• P 2 X MPUTATION RETURN F X ON JOINT/TRUST y::::: I I : F Jy4 F:'~ `.~::y::::..... . :.:~~. : :..~.: ;.;., r f: ~F : F f;: ,r` v''G.. .r. • r %. ~.~ :::f:: ~ :.~ '~ 6 fi :: ~:~ : d ~ FJ/ y f! 6 .:. /..:..~ : P ... q ACCOUNTS LINE 1 . Date Established 1 ~i~L1~'-o~f)Qy :i ~ L ~.. ... r ?p ;Y/.+ f . '~ `~~~{~ { ~'' ` ~~% . 2 count Balan e 2 : .:. . :::::.:: :..:::.::::.r::.:.:::.::.;:.::... ~:.:. . ' U:•.n y~r ! ~f':' /' .~ .~. . n: s%'%~ i ~f•'•F ~;,?: .Y:• ..~~: ;``%:. t::I~u . rcent T a x a b 1 e 3 X ~ ::::::::::.::::::..:~::::. ~..::::;:r:` :.:.:.:.:.....:.:... ::.. :.. :. :::. ,:::: <::.:::, ::..::.::.:::.::::;:. ................. ;;::;.: .:::::. ~::::::. ~::::::::.:::::::::.r :'•~~/ . .:f:::: yJ : J` /1 .iii :.6.~ : I:"~'"% `~' F / : f.. /: '~` i, yF .,.{,~: <... .:: :..:... .:... ::.... :...::.:. ::::::.: yr ./n :.l:9.. / •ri ia•: ::.;:::::::::::::.;..:::...::::..:...;:..:.: ,::,,,::...::...,::•..::.: y ..: f • : ~ .:: : ,. ,/.. . ount Sub ect to Tax 7 .SR'8~ ~~ :. ,: . /: v:. yf:f' ~~`~'~ / :cy sk ;;fir. ryf .< F~ l,':r ~:• !, : /: r:: fi~ .~: .~ ,:/.,. <.a .::., F. ::. : .; .;: ~::: :; ~ ~ . ebts and Deductions / ~ 5 ~yJ / • _ ::::..:.... ;:: . ,.':~ " ; . . . ;::::: <:.. . .::; .;:. :: ~::; F: ..... : ..::.:::: ... :.::.:.:.::.y;,::::: ::..... "fry! ':/:8'v::':'r..!_.. r::`:::`:•:. f !:.:::: f : :/Y . ount Taxable 6 ~ t ll s .............. ........... :.::. ~ .::.:.:::. ...:.:.::: s y::.:: :. ....::r :.: , :. /F Y• 9i1.. .r~ :i ik:f. :f' ,./.; r,,:9'i •~ :, H.i .r:.•:.a ~ •.fi~ : 7 . Tax Rate 7 X ~i S ~ ~ ~'~~";~~~,,., •:: ; '<%r 8 . Tax Due 8 $ ~ .. (Qy. '%~ ~'..:;:' ~ °:s'~:! :~'.f.~~i,~` t ./•.~::'.•.' ~;'•,; o:',':y?:~; :>I,hi: %1: /I r.:%r'.i :' +'l% :!~: • f•. PART DEBTS AND DEDUCTIONS CLAIMED a DATE P AID PAYEE DESCRIPTION AMOUNT PAID / 23 0 o b l 00 r to TOTAL CEnter on Line 5 of Tax Computation) S /Lf~ (• Ga Under penalties of perjury, I declare that the facts I have reported above are true, correct and complete to the best of my knowledge and belief. HOME C'1('7 ) 866 ~'~~j ~ ..- WORK C ~~~ ~ 366 7L 3y 6 /3 Jiro T PAYER SIGNATURE TELEPHONE NUMBER DATE BUREAU OF INDIVIDUAL TAXES PO BOX 280601 HARRISBURG PA 17128-0601 REV-1543 EX PENNSYLVANIA INHERITANCE IN~Ol~~i~-TION NOTICE -. ~ ,~ ... `" '- s AND i `.. ~ ; I. ~.., - ` _ ~ ~~; T`bXPAYER RESPONSE cos-oe~ a~a ~~~ _9 ~~ ~'~ vL ~~p~1#~t~3ut,~.~ ..~ FA. yf - TAX FILE N0. 21-/0'OyJ~ ACN 10130402 DATE 05-28-2010 EST. OF ANNA M ORRIS SSN 195-07-5626 DATE OF DEATH 01-23-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: JOSHUA ORRIS REGISTER OF WILLS 2579 RALEIGH RD 1 COURTHOUSE SQUARE HUMMELSTOWN PA 17036 CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS ® CHECKING TRUST CERTIF. MID PENN 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 point 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. Please call C717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 801 - 301 - 3 Date 02- O 1 - 1978 To ensure proper credit to the account, two Established copies of this notice must accompany payment to the Register of Wills. Make check Account Balance $ 1 , 182 • 44 payable to "Register of Wills, Agent". Percent Taxable X 16.667 NOTE: If tax payments are made within three Amount Subject to Tax $ 197.08 months of the decedent's date of death, Tax Rate X • 15 deduct a 5 percent discount on the tax due. Any Inheritance Tax due will become delinquent Potential Tax Due $ 29 • 56 nine months after the date of death. PART TAXPAYER RESPONSE / f f. '!~'1 h F$•. .I ri~.'l.~ Ff ~iq{~~ .6iV HF ~' A. ~ The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or check box "A" and return this notice to the Register of CHECK Wills and an official assessment will be issued by the PA Department of Revenue. ONE 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. low PART b d/ ~ e . or ~ an Complete PART 2 PART If indicating a different tax rate, please state ~~"~ ~'~~ ~ ~` ~ f' ' relationship to decedent: ~3/'d-^~So~ i ' ,• TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS ~~• "'~ `yq ' ~ - s-f .~ ~~~ LINE 1 . Date Established 1 d f ~,~~,' 2. Account Balance 2 $ ~ ~ R"a~(. ~'-1 fi ~ 3. Percent Taxable 3 X d ~f:s ' ' , ~~{~~~!y~ "~ 4. Amount Subject to Tax 4 ~ ~ •~y ~ ~.~ •' ~ '`` 70 . y ~, 5. Debts and Deductions 5 ;~ - yr',F F , ~ • .~,f ,, . ,' ~ .f 6. Amount Taxable 6 $ 0 7. Tax Rate 7 X ~~ J '.,~'s r 9 ' ,.fr / f ~• ~` '~~ •, ~ F f y~ 8. Tax Due PART DEBTS AND DEDUCTIONS CLAIMED a DATE PAID PAYEE DESCRIPTION AMOUNT PAI D ~ / / ib 3 i o ~ o~F L. $a.oc~ IUIML len~er un Lines ~ u~ ion vv ml+a.~a~+..... - ~ /V ~~ Vy Under penalties of perjury, I declare that the facts I have reported above are true, correct and complete to the best of my knowledge and belief. HOME C-1~-7 ~ S~6 ~1j 3 _ WORK C 7,7 ~ Sic ... 76 ~! 6/3 / T XPAYER SIGNATURE TELEPHONE NUMBER DATE