HomeMy WebLinkAbout08-24-10COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
GLATFELTER CHRISTOPHER A
227 LEEDY ROAD
SPRING GROVE, PA 17362
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ESTATE INFORMATION: ssrv: 200-28-770
FILE NUMBER: 2110-0342
DECEDENT NAME: GLATFELTER DONALD M
DATE OF PAYMENT: 08/ 24/ 201 0
POSTMARK DATE: 08/23/2010
COUNTY: CUMBERLAND
DATE OF DEATH: 12/ 13/2009
REV-1162 EX~11-96)
NO. CD 013246
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
10141868 ~ $91.62
TOTAL AMOUNT PAID:
REMARKS:
CHECK# 3722
SEAL
INITIALS: DM
$91.62
RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF INDIVIDUAL TAXES
PO BOX 280601
HARRISBURG PA 17128-0601
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PENNSYLVANIA INHERITANCE
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
TAX
FILE N0. 21 10-0342
ACN 1014:L868
DATE 07-2:L-2010
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CHRISTOPH GLATFELTER
227 LEEDY RD
SPRING GROVE PA 17362-8632
EST. OF DONALD M GLATFELTER
SSN 200-28-7170
DATE OF DEATH 12-13-2009
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
TYPE OF ACCOUNT
SAVINGS
CHECKING
TRUST
CERTIF.
PSE CU 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 Commonweal#h of
Pennsylvania. Please call C717) 787-8327 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 8930181659IRA50 Date 04-03-2001 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 $ 24,433.46 payable to "Resister of Wills, Asent".
Percent Taxable X 8.333
NOTE: If tax payments are made within three
Amount Subject to Tax $ 2, 03b . 04 months of the decedent's date of death,
Tax Rate )( .045 deduct a 5 percent discount on the tax due.
Any Inheritance Tax due will become delinquent
Potential Tax Due $ 91 .62 nine months after the date of death.
PaT TAXPAYER RESPONSE
~ FAILW~f TO RES~O~'!~t WILL RESl1LT IN AN €IFFICIAL TAX ASSES~IENT`
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.
ONE
BLOC 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 tiled by the estate representative.
C. ~ The above informs ion is incorrect and/or debts and deductions were paid.
Complete PART 2~ and/or PART IJ below.
PART If indicating a different tax rate, please state €~~FFICIAL USE ONI,„Y ~ AAF'
relationship to decedent:
2 PA DEPARTMENT Of REVENUE
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD
LINE 1. Date Established 1 1
2. Account Balance 2 $ 2
3. Percent Taxable 3 X 3
4. Amount Subject to Tax 4 $ C~
5. Debts and Deductions 5 - 5
6. Amount Taxable 6 $ {
7. Tax Rate 7 X 7
8. Tax Due 8 $ 8
PART DEBTS AND DEDUCTIONS CLAIMED
3^
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
Under penalties o fperjurryy,
complgM<'e~~p /the ,~~yt of/,~y
!declare that the facts I have reported above ar try correct and
s-. f"^-~//"// r.
owledge and belief . HOME C~ ~ / ) Cy' ~\-- ~-J /~c:~
W O R K C Jl. ~) ~~ ~ ~ ~~
TAXPA~ER'SIGNATIf.~E~;~ TELEPHONE NUMBER DATE
TOTAL (Enter on Line 5 of Tax Computation) $
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