HomeMy WebLinkAbout10-06-10 (2)COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
BARRICK REVENNA C
102 HOLLENBAUGH RD
CARLISLE, PA 17015
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PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ESTATE INFORMATION: ssN: 203-~0-7307
FILE NUMBER: 2110-0996
DECEDENT NAME: WARNER MARY E
DATE OF PAYMENT: 10/06/2010
POSTMARK DATE: 10/06/2010
COUNTY: CUMBERLAND
DATE OF DEATH: 08/28/2010
REV-1162 EX111-961
NO. CD 013451
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
10155131 ~ 51,132.29
TOTAL AMOUNT PAID:
REMARKS:
CHECK# 552714
SEAL
INITIALS: CJ
51,132.29
RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF INDIVIDUAL TAXES
PO BOX 28D601
HARRISBURG PA 17128-0601 _17 i'~~_
REV-1543 EX RFP (OB-OB)
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE ~y
-'{-~i ~j" AND FILE N0. 21~~C``r~'!G
,,~ I ;TAXPAYER RESPONSE ACN 10155131
~ -~" DATE 09-29-2010
Zoso acT -~ A~ ~a~ a~
EST. OF MARY E WARNER
CLERK~.lr SSN 203-10-7307
ORPHANS ~~(~~ CO NTYF DEATMUMBERLANDOlo
CUMR>~~LP~I~ ~~ _, . FP.
REMIT PAYMENT AND FORMS T0:
REVENNA C BARRICK REGISTER OF WILLS
102 HOLLENBAUGH ROAD 1 COURTHOUSE SQUARE
CARLISLE PA 17015 CARLISLE PA 17013
TYPE OF ACCOUNT
SAVINGS
CHECKING
TRUST
CERTIF.
MEMBERS 1ST FCU 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-pawed decedent, you were a ioint 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 forty
and return it to the above address. This account 15 taxable in accordance with the Inheritance Tax laws of the Cowwonwealth of
Pennsylvania. Please call 1717) 787-8327 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 318841-50 Date 12-24-2008 To ensure prover credit to the account, two
Established copies of this notice must accowpany
payment to the Register of Wills. Make check
Account Balance $ 52, 972.99 payable to "Register of Wills, Agent".
Percent Taxable X 50.000
NOTE: If tax paywents are made within three
Amount Subject to Tax $ 26,486.50 months of the decedent's date of death,
X .045 deduct a 5 percent discount on the tax due.
Tax Rate Any Inheritance Tax due will become delinquent
Potential Tax Due $ 1 ~ 191 • 89 nine months after the date of death.
PART TAXPAYER RESPONSE
°AI R W S ~ iJ~i A O ~!_ Tl ~~° ~ St~~#i°
A. ~ The above information and tax due is correct.
Remit paywent to the Register of Wills with two co pies of this notice to obtain
a discount or avoid interest, or check box "A" and return this notice to the Register of
C H E C K Wills and an official assessment will be issued by the PA Department of Revenue.
ONE
C
B L 0 C K B. ~ The above asset has been or will be reported and tax p aid with the Pennsylvania Inheritance Tax return
0 N L Y to be filed by the estate representative.
C. ~ The above inforwa ion is incorrect and/or debts and deductions were paid.
Cowplete PART 2~ and/or PART ~ below.
PART If indicating a different tax rate, please state
relationship to decedent:
TAX RETURN - COMPUTATION
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
8. Tax Due
OF TAX ON JOINT/TRUST ACCOUNTS
1
2
3 X
4
5
6 '~
7 X
8
OFFICIAL USE ONLY U AAA
PA DEPART#ENT OF #~EYENUE
a
PAD _
2
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3 ~~\
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7 _`_.
PART DEBTS AND DEDUCTIONS CLAIMED
naTE PAID PAYEE DESCRIPTION AMOUNT PAID
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. HOME C )
WORK C )
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