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HomeMy WebLinkAbout06-17-10COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: NELSON JOHN B 158 OAK HILL ROAD CARLISLE, PA 17015 -------- fold PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ESTATE INFORMATION: SSN: 184-36-6096 FILE NUMBER: 2109-1035 DECEDENT NAME: NELSON JAMES B DATE OF PAYMENT: 06/ 1 7/2010 POSTMARK DATE: 06/ 16/2010 COUNTY: CUMBERLAND DATE OF DEATH: 10/ 20/ 2009 REV-1162 EX~11-96) NO. CD 012929 ACN ASSESSMENT AMOUNT CONTROL NUMBER 10129135 ~ 5413.18 TOTAL AMOUNT PAID: REMARKS: CHECK# 1902 SEAL INITIALS: DM $413.18 RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES PO BOX 280601 HARRISBURG PA 17128-D601 _., i.,_ l1 ^t, -; .~ i ~ ~ 1ii610-is4E~E7t~SP (09-V8), PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE AND FILE ;- TAXPAYER RESPONSE ACN DATE N0. 21 09-1035 10129135 05-20-2010 2010 Jt3 17 A~111 ~ 10 G~.EP~ ~F 4RPNA~~`S ~~~JRT JOHN B NELSON 158 OAK HILL RD CARLISLE PA 17015 EST. OF JAMES B NELSON SSN 184-36-6096 DATE OF DEATH 10-20-2009 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SgUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS ® CHECKING TRUST CERTIF. SOVEREIG N 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 C717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 3381130587 Account Balance Percent Taxable Date 07-02-2001 Established $ 41,319.23 X 8.333 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". NOTE: If tax payments are made within three Amount Subject . to Tax $ 3, 443.13 months of the decedent's date of death, Tax Rate ~( ~ ~ a deduct a 5 percent discount on the tax due. ~ti.,T „/~ /~ Any Inheritance Tax due will become delinquent Potential Tax Due 7" nine months after the date of death. PART TAXPAYER RESPONSE _, .. tip: , .: ,, .:,: .. ,;, ~,,.,.. .. : ~ .~,r:.~ <<,, F :::: . 9 y ; ,,v' ' .+.'.. ;.,.,~`,'~ y:;:,'~9' „Y. ;U,.~`c'~~ i •j'•r ~.:g,,~.f:sr .; 56,jfk, :::3/;, , r•': if:{; A. ~ The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain C H E C K 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 f indicating a different x~r1~te, lease state ., relationship to decedent: ~r,~~,/p ~~~'~ ~ , ,. TAX RETURN - COMPUTATION LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due OF TAX ON JOINT/TRUST ACCOUNTS 1 2 +~ 3 X 4 5 - 6 7 X ~ I'~' 8 $ ~• PART DEBTS AND DEDUCTIONS CLAIMED 0 DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts complete to th~best of my kjjowledge and belief. AYER have reported above are true, correct and HOME C ~~7 ) ~~~1'~I~S~ / WORK ( ) fA-Z` SAO TELEPHONE NUMBER DATE iuip-~ ctnter on ~lne 5 of Tax Computation) 8 ,F ,~_ vi ~ '0~ '~ ~ ~ 2~~pJU~ ~ 7 A~ ~~ III: t0 ~ _ ~~ c~~~~ ~~ N 4RF~~fA~~`w ~~C~~~~ .~; ~. r , -z~ ~~ ...~ ~:; ~ +. ~ ~`" ri ;: ~ ~ r, ~ ~~ ~ ~ c1 ~ ~ ~ © ~°" ~ `~` '~ ~ p ~,~ ~ ~.- ,,.5 cr, ~ .. ~ ,~ -- - ~ ~ ~ ~ ~ a C~ ~ ~ ~~ M W ~~ ~~ ~~ ~~ y~ ~~ f _~ ~~ ~ ~ 1 ~. ~r