HomeMy WebLinkAbout09-15-10COMMONWEALTH OF s'E~I~"~"'_VAtiIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL Tfi,:<c~
DEPT. 280601
HARRISBURG, PA 17128-OEO?
RECEIVED FROM:
MANTIS DORIS J
33 S 18TH STREET
CAMP HILL, PA 1701 1
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PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ESTATE INFORMATION: SSN: 201-18-1849
FILE NUMBER: 2110-0864
DECEDENT NAME: WILLEY BETTY J
DATE OF PAYMENT: 09/ 1 5/ 2010
POSTMARK DATE: 09/ 14/2010
COUNTY: CUMBERLAND
DATE OF DEATH: 08/07/2010
REV-1162 EX{11-96t
NO. CD 013356
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
10150622 ~ $ 2, 902.58
TOTAL AMOUNT PAID:
REMARKS:
V f° y „~
1/
SEAL
$2,902.58
INITIALS: DM
RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
PENNSYLVANIA I
BUREgU pF INDIVIDUq~ TAXES N H E R I TA N C
Po Box 280601 _ INFORMATIp E TAX
HARRISBURG pq ~~~''""; N NOTICE
17128-0601 r AND
". ... '`~ ~ TAXPAYER RES
: ~ . ,~,~~ FILE Np •
4. +4<~ ~ ~~,-~SG3.~X AFP.:'C~8.08) PONSE 21 1 0 -
ACN 0864
10150622
~01~ ~~p 1 ~ P DarE o9-09-2010
2~ 0~
EST. OF BETTY ~ TYPE OF ACCOUNT
ORPG~.~~?~' ~'`,~; W I L L E Y
SSN
~~`~' ~ DATE 201 -18 -1849 ^ SavrNGs
G ~ ~0 ~T of
DORIS (.~P,~~";~: ~,[r`~lLr-, +~''~ ~ COUNTY DEATH 08-07-2p10 ^ CHECKING
CA S 18TH STMANTIS ~ ~ ~ ~ ~~ CUMBERLAND ^ TRUST
REMIT PgyMENT
MP HILL AND FORMS T0: ~ CERTIF.
REGISTER OF WILLS
PA 17011-4809 1 COURTHOUSE
CARLISLE pA SQUARE
17013
PNC BANK NA
potential
tax due. Records provide
If you feel indicate that d the Department
and return it he information is at the death of the with the
to incorrect above_ information
Pennsvlvar,ia. the above address. please obtain named decedent below, which has
written ,
Please call ;717) This account is t correction from YOU were a joint been used in
C 0 MP L E T 787--8327 with axable in accords the owner/beneficiar alculating the
E PAR T 1 auestioris. financial institutio
B E L 0 W * nce with the Inheritance Tax n' attach a co of this account.
Account No. SEE REVERSE $jD laws of the PY tO this form
0000319 E FOR FILING commonwealth of
00292393 Date AND PAYMENT
account 05-12-2006 INSTRUCTIONS
Balance Established
Percent To ensure pro
Taxable $ copies Per credit to
AmoU 58 ~ 051.57 °f this notice must the account, two
nt Sub ' payment
J e c t accompan
to Tax
~ ~ ~ Payable to "Re Register of Wills. y
Tax Rate $ 50' sister Make
29 °f Wills, Agent", check
Potential X ' 025.79 NOTE:
PART Tax Due $ • 15 months of the payments are made within
deduct a 5 decedent's date of three
Descent death, •'~
~+ , 353. $ 7 Any Inher - discount on t ~ `~ ~ j
TARP months
FAx;LURE AYER RES nine itaaftera{heUdatell becometa ltlne. y
TO RESppND PONSE of death, fluent
WILL RESULT IN AN OFFI`C
q' ~ The above
information and tax due is correct.
CHECK Remit Payment IAL TAx ASSESSMENT
a discount to the Register
O N E Wills and or avoid interest of Wills with two
BLOCK an off ~ or check box "A" and pies of this
icial assessment return notice to obtain
B. will be issued this notice to
0 N L Y The above asset has by the Pq pe the Register of
to be filed been or will partment of Revenue.
by the estate be reported and
~ representative, tax Paid with the P
^ The above informs ion ennsylvania Inheri
Complete PgRT is incorrect tance Tax return
PART If 2 and/or PART ~ and/or debts and
indicating a differe below, deductions
^ were paid.
nt
relationship to decedent; tax rate
please state
TAX RETURN - COMP(-T
LINE 1. Date ATION OF TAX ON dFFiCIAL
Established JOINT/TRUST USE DNL Y
2• Account 1 ACCOUNTS PA DEPARTMENT OF ^ AAF
Balance PAD REVENUE
3• Percent Taxable 2 $
4. Amo 3 X 1
unt Subject to Tax q ,~` 2
5• Debts and Deductions 5
6, _ 3
Amount Taxable 4
~• Tax Rate 6 $
8• Tax Due ~ X 5
s $ 6
PART
7
DEBTS AND DEDUCTIONS 8
DATE PAID CLAIMED
PAYEE
DESCRIPTION
AMOUNT PAID
finder penal TDTAL CEnter
comp t ties of perjur on Line 5 of on)
e to the best y' r declare that the Tax Computati
mY knowledge an facts I have $
w d belief, reported
above
~A P ER SIGNATU ~ ~ HOME ~ ~, jre true, correct and
WORK
TEL EPHON ~ ~~~
NUMBER ~~ ~lj