HomeMy WebLinkAbout07-07-10COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
DUNN RUTH JANE
4000 WOODVALE ROAD
HARRISBURG, PA 17109
fold
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ESTATE INFORMATION: ssN: ~ 65-i 8-sss7
FILE NUMBER: 2110-0680
DECEDENT NAME: DUNN RICHARD F
DATE OF PAYMENT: 07/07/2010
POSTMARK DATE: 07/06/2010
couNTY: CUMBERLAND
DATE OF DEATH: 03/07/2010
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
10137227 ~ 575.90
TOTAL AMOUNT PAID:
REMARKS:
CHECK#7186
SEAL
INITIALS: CJ
RECEIVED BY:
575.90
GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REV-1162 EX111-961
NO. CD 013027
REGISTER OF WILLS
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
+ ~~,'" AND FILE N0. 21~-~ ry,
BUREAU OF INDIVIDUAL TAXES +. ~ ~'
PD Box zsocol ~ -. ,~ ~aA?XR~AYER RESPONSE ACN 10137227
HARRISBURG PA 17128-0601 1~ d,,, # r ~ ,~~ ~;;,;.x
DATE 06-30-2010
REV-1543 EX AFP (OB-OA)
~Q~Q ~~L _~ PM ~~; ( ~ TYPE OF ACCOUNT
t EST. OF RICHARD F DUNN ~ SAVINGS
["~1 COV (~ $$N 165-18-9897 ® CHECKING
(}R~HANp'S~~ C~UR1' DATE OF DEATH 03-07-2010 ~ TRUST
irta~+n 1~1/5ty~ ~ p~ COUNTY CUMBERLAND ~ CERTIF.
REMIT PAYMENT AND FORMS T0:
RUTH J DUNN REGISTER OF WILLS
824 LISBURN RD APT 522 1 COURTHOUSE SQUARE
CAMP HILL PA 17011-7100 CARLISLE PA 17013
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 C717J 787-8327 xith questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 1000613179453 Date 01-02-1950 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 ,Q 3, 036.02 payable to "Register of Wills, Agent".
Percent Taxable X 16.667
NDTE: If tax payments are made within three
Amount Subject to Tax $ 506.01 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 $ 75 • 90 nine months after the date of death.
PART TAXPAYER RESPONSE
FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT
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
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 ~ and/or PART ~ below.
PART If indicating a different tax rate, Please state
relationship to decedent:
,TAX RETURN - COMPUTATION
LANE 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
8 $
PART
3^
PAD
1
2
3
4
5
6
7
8
OFFICIAL USE ONLY [~ AAF
PA DEPARTMENT OF REVENUE
DEBTS AND DEDUCTIONS CLAIMED
TOTAL (Enter on Line 5 or +ax ~omputa a un~
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. H OME C ) ~~ G g
WORK C ) /b
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DATE PAID PAYEE DESCRIPTION AMOUNT PAID
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