HomeMy WebLinkAbout07-29-10COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1 7 1 28-0601
RECEIVED FROM:
CONAWAY JOAN L
7200 THIRD AVE U404
SYKESVILLE, MD 21784
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PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ESTATE INFORMATION: SSN: 214-62-2503
FILE NUMBER: 2110-0771
DECEDENT NAME: CONAWAY JOHN T
DATE OF PAYMENT: 07/ 29/ 2010
POSTMARK DATE: 07/27/2010
CouNTY: CUMBERLAND
DATE OF DEATH: 02/ 1 5/201 0
REV-1162 EX(11-«6)
NO. CD 0131 19
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
10140156 ~ $59.18
TOTAL AMOUNT PAID:
REMARKS:
559.18
CHECK# 202
INITIALS: DM
SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
~__........~ vwure INHERITANCE TAX
PENNSYL
INFORMATION NOTICE
AND
BUREAU of INDIVIDUAL TAXES T AX P AY E R R E S P O N S E
PO BOX 280601
HARRISBURG PA 17128-0601
REV-1543 EX AFP (OB-OB)
O . ~ a n ++...-
EST. OF JOHN T CONAWAY
SSN 214-62-2503
DATE OF DEATH 02-15-2010
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
TYPE OF ACCOUNT
a SAVINGS
^ CHECKING
^ TRUST
^ CERTIF.
L CONAWAY REGISTER OF WILLS
JOAN 1 COURTHOUSE SQUARE ~?
7200 THIRD AVE U404 CARLISLE PA 17013 ~?~ ~ ;.-
SYKESVILLE MD 21784-5201 - ._
~' ~ C'7 ~'
-~ r-- ~°~
A ~, tv
•^ ~
_x.
) .. a_
~.~.. r
account
provided the Department with thde decedent 1 you were a hjoint owner/bene•f ic~a.alof lam 9 the
PNC BANK NA a copy ta.aj<his form
potential tax due. Records indicate that at the death of the above-name ^J
If you feel the information is incorrect, pleaun obtain written correction from the financial institution, attl ~'- .....
t is taxable in accordance with the Inheritance Tax laws of the-ddmmonwealt~h of _ I T,
and return it to the above address. This acco -~ ~` ,-~ ~` ~)
Pennsylvania. Please call :7173 787-0327 :rite questions.
ART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONSC.J wo
COMPLETE P
Account No. 000005555606594 Date 09-08-1989 To ensure proper credit to the account, t
copies of this notice must accompany
Established payment to the Register of Wills. Make check
$ 2, 630.15 payable to "Register of Wills, Agent".
Account Balance 50.000
Percent Taxable X NOTE: If tax payments are made within three
$ 1 , 315.08 months of the decedent's date of death,
Amount Subject to Tax • 045 deduct a 5 percent discount on the tax due.
Tax Rate X Anv Inheritance Tax due will become delinquent
$ 5 9 .1 8 nine months after the date of death. -_
Potential Tax Due
PART TAXPAYER RESPONSE
1 ~U<RE TO RESPt3ND WILL RESULT IN AN OFFICIAL tAX ASSESSMENT
^ FAI
A, ~ The above information and tax due is correct.
Remit payment evoideinterestr or wheck box h'A'~oand preturn this notice to theaRegister of
a discount or
C H E C K Wills and an official assessment will be issued by the PA Department of evenue.
B L 0 C K B. The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance 'Tax re urn
ONE
0 N L Y ~ to be filed by the estate representative.
C, ^ The above informs ion is incorre3t belowr debts and deductions were paid.
Complete PART ~2 and/or PART ^
OFFICIAL USE DNLY ^ AAF
PART If indicating a different tax rate, please state PA DEPARTMENT DF REVENUE
relationship to decedent:
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD1
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
1
2
3
4
$
X
$ 2
3
4
5
5
6
7
8 -
`~
X
$ 6
7
$
PART
DATE
DESCRIPTION
FILE N0. 21 ' ~L' "V~~
ACN 10140156
DATE 07-08•-2010
AMOUNT PAID
s
TOTAL CEnter on Line 5 of Tax Computation)
Under penalties of perjury, I declare that the facts I have reported above ~~ true,~corre t and~~~-
nowledge and belief . HOME ~~ .
o. a tq the bes~~ of :~4 _
._ . ~~-~~•- L/ WORK ( ~ -
- D E
';, c~~?~ Y '~"~~ ~~~~ __ TELEPHONE NUMBER -
DEBTS AND DEDUCTIONS CLAIMED
SIGNATUR