HomeMy WebLinkAbout06-14-10COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ZOOK BETTE J
24 GUNPOWDER ROAD
MECHANICSBURG, PA 17050
fold
ESTATE INFORMATION: ssN: 2~s-24-saz~
FILE NUMBER: 2110-0585
DECEDENT NAME: DAWSON HARRY H
DATE OF PAYMENT: 06/ 14/201 0
POSTMARK DATE: 06/1 1 /201 0
couNTY: CUMBERLAND
DATE OF DEATH: 03/31 /201 0
REV-1162 EX(11-96)
NO. CD 012910
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
10131271 ~ $52.20
TOTAL AMOUNT PAID:
REMARKS:
CHECK#1369
SEAL
INITIALS: CJ
552.20
RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
PENNSYLVANIA INHERITANCE T
INFORMATION NOTICE
BUREAU OF INDIVIDUAL TAXES A N D
PO BOX 280601
HARRISBURG PA 17128-0601 z r' f"$ ("~i`:Nr~ f~~~PAYER RESPONSE
REV-1543 EX QEP. cQaFDDr ! .y •yi ;.~ 4
FILE N0. 21 •--~(~ -(~S~s
ACN 10131271
DATE 06-04-2010
[~ { ~ JUN 14 Pti 12~ 41
CUP,°~~` !='''~' ~? . PA,
BETTE J ZOOK
24 GUNPOWDER RD
MECHANICSBURG PA 17050
EST. OF HARRY H DAWSON
SSN 218-24-9821
DATE OF DEATH 03-31-2010
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
TYPE OF ACCOUNT
SAVINGS
® CHECKING
TRUST
CERTIF.
M & T 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
Pennsylvania. Please call 1717) 787-8327 with questions.
COMPLETE PART I BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 27623858 Date 05-24-2004 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 $ 6,960.38 payable to "Register of Wills, Agent".
Percent Taxable X 16.667
Amount Subject to Tax
$
1
160
09 NOTE: If tax payments are made within three
'
,
. months of the decedent
s date of death,
TaX Rate X .045 deduct a 5 percent discount on the tax due.
Potential Tax Due
'~`
52
20 Any Inheritance Tax due will become delinquent
• nine months after the date of death.
RT
P TAXPAYER RESPONSE
A
~
FAILURE TO R 4~ WILL RESULT IN AN OFFICIAL TAX ASSESSMENT
A. II,~'The above information and tax due is correct.
uu 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.
C 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.
Complete PART 2~ and/or PART IJ below.
PART If indicating a different tax rate, please state DFFICIAL USE ONLY ~ AAF
relationship to decedent: PA DEPARTMENT OF REVENUE
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD
LINE 1. Date Established 1 1
2. Account Balance 2 +fi 2
3. Percent Taxable 3 X 3
4. Amount Subject to Tax 4 $ 4
5. Debts and Deductions 5 S
6. Amount Taxable 6 $ b
7. Tax Rate 7 X 7
8. Tax Due 8
PART DEBTS AND DEDUCTIONS CLAIMED
S^
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
Under penalties of perjury, I declare that the facts I have reported above area"t//r~-ue, cor~rtect and
complete to the best of my knowledge and belief. HOME C`~~~ ) CD"1~- ~`1 lO
W O R K C --~- ~Q - I 1-~ ~
TAYPAVFR CT(,NATIIR TFI FP41 f1NF NIIMRFR T1ATG
TOTAL (Enter on Line 5 of Tax Computation) S