HomeMy WebLinkAbout07-26-10COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1 7 1 28-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 013100
MARSICO DONNA J
50 OLIVER ROAD
ENOLA, PA 17025
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
-------- fold
ESTATE INFORMATION: SSN: 189-09-0673
FILE NUMBER: 2110-0448
DECEDENT NAME: BAILEYS ELIZABETH C
DATE OF PAYMENT: 07/ 26/ 201 0
POSTMARK DATE: 07/23/2010
COUNTY: CUMBERLAND
DATE OF DEATH: 04/03/2010
REMARKS: DONNA J MARSICO
SEAL
CHECK# 875
10139897 $150.09
TOTAL AMOUNT PAID:
REV-1 "162 EX(11-961
;~ 150.09
INITIALS: WZ
RECEIVED BY: GLENDA EARNER STRASBAUC~H
REGISTER OF WILLS
REGISTER OF WILLS
Iocn~NSYLVANIA INHERITANCE TAX
f INFORMATION NOTICE
AND
BUREAU OF INDIVIDUAL TAXES TAXPAYER RESPONSE
PO BOX 280601
HARRISBURG PA 17128-0601
REV-1543 EX AFP <OB-OB) - '
DONNA J MARSICO
OLIVER RD
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C/0 50 pA 17025
ENOLA
FILE NO. 21 10-0448
ACN 10139897
DATE 07-07-2010
EST. OF ELIZABETH C BAILEYS
SSN 189-09-0673
DATE OF DEATH 04-03-2010
COUNTY CUMBERLAND
.}REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
TYPE OF ACCOUNT
^ SAVINGS
^ CHECKING
TRUST
^ CERTIF.
provided the Department with the information below, which has been used in coalculating t e
cedent, you were a joint owner/benefi<:iarv °ftohthiscformt
SOVEREIGN BANK
" formation is incorrect, please obtain written correction from the financial institution, attach a c pv
potential tax due. Records indicate that at the death of tee in accordance with the Inheritance Tax laws of the Commonwealth of
If you feel the in
and return it to the above address. This account is taxab
Pennsylvania. Please call (71.7) 787-SE?7 rith quections- r
pW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTION two g
COMPLETE BART 1 fEL
o. 0765144779 11-17 -1995 To ensure proper credit t,* accompanynt, %
Account N
Account Balance
Percent Taxable
Amount Subject to Tax
Tax Rate
Potential Tax Due
Date copies of this notice mu_,
payment to the Register of Wills. Make check
Established ~+
payable to 'Register of Wills, Agent".
1 0 ~ • ~ ~ NOTE: If tax Payments are made within three
X 1 ~ 0 ~ 0 • 57 months of the decedent' s date of death,
$` . 1 5 ~ deduct a 5 percent discount on the tax due.
Anv Inheritance Tax due will become delinquent
X 150 09 ~ nine months after the date of death.
TAXPAYER RESPONSE
PART
1 TO RESPQNiI WILL RESULT IN AN OFFICIAL TAX ASSESSi"4ENT"
^ FAILI~~IE
A, The above information and tax due is correct.
LLJJ Remit payment to the R{e~estr or check boxh'A'woandpreturn this notice to theaRegister of
a discount or avoid in
' 1 assessment will be issued by the PA Department of eve~nue.
CHECK
ONE
BLOCK
ONLY
Wills and an officia
The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
B.
to be filed by the estate representative
C, ^ The above inform2 land/or1PARTre3t below. debts and deductions were paid. t--~
Complete PART ~ ~ „r ., ):eC l1hi1 Y i 1 AAF
If indicating a different tax rate, Please state
PART relationship to decedent:
- COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
TAX RE TURN
LINE 1.
1
Date Established
2. 2
Account Balance
X
3.
3
Percent Taxable
4. Amount Subject to Tax 4
5. Debts and Deductions 5
6. 6
Amount Taxable
X
7.
7
Tax Rate
T.
° . ~ a,. "-
PART
0
DATE PAID PAYEE
U t' t- 1 ~. t n L ~ ~- - - - .._._.
PA DEPARTMENT OF REVENUE
PAD
1
2
3
4
5
6
7
8
LAIMED
DESCRIPTION
TOTAL CEnter on Line 5 of Tax Computation)
AMOUNT PAID
s
Under Penalties of perjury, I declare that the facts I have reportedCa;;~ ~e~ ~\~ co~~~a
H O M E _~ -~ ` ~ ~-.`~
complete to the b st of my knowledge and belief . ~ WORK C ~ 1 (~~ ~ , a 3 ~ ~ ~
~` 4 • .~,~ DATE
TELEPHONE NUMBER
TAXPAYER SIGNATURE
DEBTS AND DEDUCTIONS
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