HomeMy WebLinkAbout09-27-10 (2)COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1 7 1 28-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
CARPENTER DENISE A
98 BOOT ROAD
NEWTOWN SQUARE, PA 19073
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ACN
ASSESSMENT
CONTROL
NUMBER
ESTATE INFORMATION: SSN: 184-10-7688
FILE NUMBER: 2110-02$1
DECEDENT NAME: MIRRA EDWARD
DATE OF PAYMENT: 09/ 27/ 2010
POSTMARK DATE: 09/25/2010
couNTY: CUMBERLAND
DATE OF DEATH: 02/02/2010
AMOUNT
10131579 ~ $264.30
i
TOTAL AMOUNT PAID:
REMARKS: RECEIPT TO ATTY
CHECK# 1010
SEAL
~ 264.30
INITIALS: HMW
RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REV-1162 EX;~11-96)
NO. CD 013416
REGISTER OF WILLS
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
BUREAU OF INDIVIDUAL TAXES A N D
PD Box zao6ol TAXPAYER RESPONSE
HARRISBURG PA 17128-D601
REV-1543 EX AFP (08-08)
FILE N0. 21 10-0281
ACN 10131579
DATE 06-08-2010
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EST. OF EDWARD MIRRA
SSN 184-10-7688
DATE OF DEATH 02-02-2010
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
TYPE OF ACCOUNT
SAVINGS
CHECKING
TRUST
CERTIF.
PNC BANK NA 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 Commonwealth n+F
Pennsylvania. Please call C717) 787-8327 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 000031200171164 Date 12-01-1999
To ensure proper credit to the account, two
Established copies of this notice must accompany
Account Balance $` 17, 620.17 Payment to the Register of Wills. Make check
payable to "Register of Wills, Agent".
Percent Taxable X 33.333
Amount Subject to Tax $ 5, 873.33 NOTE: If tax payments are made within three
months of the decedent's date of death,
Tax Rate X . 045 deduct a 5 percent discount on the tax due.
Potential Tax Due $ 264.30 Any Inheritance Tax due will become delinquent
nine months after the date of death.
PART TAXPAYER RESPONSE
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CHECK
ONE
BLOCK
ONLY
ine above information and tax due is correct.
Remit payment to the Register of Wills with two copies of this notice to obtain
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.
B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
to be filed by the estate representative.
C. ~ The above information is incorrect
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or debts and deductions were paid.
RT 2~ and/or PART ~ below.
PART If indicating a different
' tax rate, please state
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PART DEBTS AND DEDUCTIONS CLAIMED
DATE PAID PAYEE DESCRIPTION
AMOUNT PAID
TOTAL CEnter on Line 5 of Tax Computation) g
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 )
TAXPAYER SIGNATURE TELEPHONE NUMBER
DATE