HomeMy WebLinkAbout10-06-10 (4)REV-1162 EX(11-961
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OP INDIVIDUAL TAXES
DEPT. 260601
HARRISBURG, PA 17126-0601
RECEIVED FROM:
BARRICK REVENNA C
102 HOLLENBAUGH RD
CARLISLE, PA 17015
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ESTATE INFORMATION:
FILE NUMBER:
DECEDENT NAME:
DATE OF PAYMENT
POSTMARK DATE:
COUNTY:
DATE OF DEATH:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
SSN: 203-10-7307
2110-0996
WARNER MARY E
10/06/2010
10/06/2010
CUMBERLAND
08/28/2010
TOTAL AMOUNT PAID:
REMARKS:
CHECK# 552716
SEAL
INITIALS: CJ
RECEIVED BY:
NO. CD 013453
5152.75
GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
ACN AMOUNT
ASSESSMENT
CONTROL
NUMBER
_ ,,_
BUREAU OF INDIVIDUAL TAXES "f ,`~~' ~'',~'r -
PO BOX 280601 I!
HARRISBURG PA 17128-0601 '~` ~~~ ~ , ~ ;
cbx FY RFP (08-08)
PENNSYLVANIA INHERITANCE TAX //yy~~
INFORMATION NOTICE FILE N0. 21"~~'~r~~
AND ACN 10155129
' TAXPAYER RESPONSE DATE 09-29-2010
C~~g~ ~ ~ ,
ORPH~h S`~ ~~(1RTPA.
CUP~R,_.~_ ._ ~.. ,
REVENNA C BARRICK
102 HOLLENBAUGH RppA,D17015
CARLISLE
EST. OF MARY E WARNER
SSN 203-10-7307
DATE OF DEATH 08-28-2010
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
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 indicatoe that at the death of the above-namededecedent, You were a ,joint owner/beneficiary of this acco
rrect, please obtain written correction with the financial institution, attach a copy to this form
e Inheritance Tax laws of the Commorn+ealth of
If you feel the information is inc
and return it to the above address. This account is taxable in accor anc
Pennsylvania. Please call (717) 787-8327 y:ith questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTION
Date 11-30-2007 To ensure proper credit to the account, two
Account No. 318841 - 05 copies of this notice must accompany
Established payment to the Register of Wills. Make check
7,146.28 payable to "Register of Wills, Agent"•
NOTE: If tax payments are made within three
Account Balance X 50.000
Percent Taxable 3,573.14 months of the decedent's date of death,
Amount Subject to Tax $ .045 deduct a 5 vercent discount on the tax due.
X Any Inheritance Tax due will become delinquent
TaX Rate 160.79 nine months after the date of death.
Potential Tax Due $
TAXPAYER RESPONSE
PART C I IWr TRAX A E5
l-IL~JR°E ~O ~R~SPO 3~ILL~ R \ 1~LT ~IN A~1
p, ~ The above information and tax due is correct.
Remit payment to the Register of Wills with two copies of this notice to obtain
Willscandtanrofficialnassessment will beoissued by the PA Depa tment of Revenue9ister of
CHECK
BLOCK 1 B. ~ The above asset has been or will be reported and tau paid with the Pennsylvania Inheritance Tax re ur
ONE
_J to be filed by the estate representative.
C N L Y _ eductions were paid.
O C, ~ The above informs ion is incorre3t be owr debts and d
Complete PART ~2 and/or PART
FIC~IAL~' USA ~LY s^ `p'F
If indicating a different tax rate, please state
pART
relationship to decedent: z
TAX RETURN - COMPUTATION
LINE 1. Date Established
2. Account Balance
3. Percent Taxable
4. Amount Subject to Tax
5. Debts and Deductions
(>, Amount Taxable
7. Tax Rate
JOINT/TRUST ACCOUNTS f~AD
OF TAX ON
1
2 $
3 X
4 '~
5
6 `~
~ X
8 '~
OF
PA DEPARTMENT OF REVENUE
1
2
3
4
5
6
7
8
DEBTS AND DEDUCTIONS CLAIMED
PART
DESCRIPTION AMOUNT PAID
DATE PAID PAYEE
s
TOTAL (Enter on Line 5 of Tax Computation)
...(
Under penalties of perjury, I declaeeandabelieffacts I have HOME ed(above ~ e true, ~..••--- ---
complete to the best of my knowled9 WORK ~ ~
DD A~-
TELEPHONE NUMBER