HomeMy WebLinkAbout06-24-10 (3)COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
COLLINS RUTH B
207 S. ORANGE STREET
CARLISLE, PA 17013
fold
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ESTATE INFORMATION: ssN: 4o7-s4-s6i7
FILE NUMBER: 2110-0528
DECEDENT NAME: BARYON LELA T
DATE OF PAYMENT: 06/ 24/ 201 0
POSTMARK DATE: 06/24/2010
COUNTY: CUMBERLAND
DATE OF DEATH: 03/27/2010
REV-1162 EX111-96)
N0. CD 012971
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
10120397 ~ S 18.46
TOTAL AMOUNT PAID:
REMARKS:
CHECK# 549
SEAL
INITIALS: DM
$18.46
RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF INDIVIDUAL TAXE$
PO BOX 280601
HARRISBURG PA 17128-0601 - ,. ,
' .. ..-,'~l_7~43,.~ a'*P COB-m))
ZG~0.3~~ ~4 Ar`~ 10~ 2
ORPH,~~ ~~ ~ JURY
L~~~i~ i"
~' . ~A.
RUTH B COLLINS
207 S ORANGE STREET
CARLISLE PA 17013
EST. OF LELA T BARYON
SSN 407-64-9617
DATE OF DEATH o3-27-2010
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
TYPE OF ACCOUNT
SAVINGS
® CHECKING
TRUST
CERTIF.
MEMBERS 1ST FCU 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 ioint owner/beneficiary of this account.
If you feel the information is incorrect, vlease 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 Inhe r_tance 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. 223251-1 1 Date 01-19-2006 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 $ 863.59 payable to "Register of Wills, Agent".
Percent Taxable X 50.000
NOTE: If tax payments are made within three
Amount Subject to Tax $ 431.80 months of the decedent's date of death,
Tax Rate X .045 deduct a 5 percent discount on the tax due.
Any Inheritance Tax due will become delinquent
Potential Tax Due $ 19 • 43 nine months after the date of death.
PART TAXPAYER RESPONSE
^ ,
URE TO RESPOkD WILL RESULT IN AN OFFICIAL TAX ASSESSMENT
FAI
L
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
C H E C K 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 information is incorrect and/or debts and deductions were paid.
Complete PART 2~ and/or PART ~ below.
PART If indicating a different tax rate, please state
relationship to decedent:
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
OFFICIAL USE ONLY ~ AAF
PA DEPARTMENT OF REVENUE
OF TAX ON JOINT/TRUST ACCOUNTS PAD
1
2
3 X
4
5
6
7 X
8
I
2
3
4
5
6
7
8
3`/. /
PART DEBTS AND DEDUCTIONS CLAIMED
0
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE N0. 21 -~~" ~~~
ACN 10120397
DATE 04-08-2010
Und r penalties of perjury, I declare that the facts I have reported above are true, +c7o(rrect and
~~ tq~he-gybes of my knowledge and belief. HOME C `~~~ ) ~-~.3-- /p5-7
t/,(~~ WORK C ~I/7 ~ ~~3 l7S ~ ~ Z3 /v
-__-__.-__ _-_..--....~ rr, rnunur ununrn n rr
TOTAL CEnter on Line 5 of Tax Computation) s