HomeMy WebLinkAbout09-27-10 (5)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
NO. CD 013420
CARPENTER DENISE A
98 BOOT ROAD
NEWTOWN SQUARE, PA 19073
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ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
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ESTATE INFORMATION: SSN: 184-10-7688
FILE NUMBER: 2110-0281
DECEDENT NAME: MIRRA EDWARD
DATE OF PAYMENT: 09/27/2010
POSTMARK DATE: 09/25/2010
COUNTY: CUMBERLAND
DATE OF DEATH: 02/02/2010
REMARKS: RECEIPT TO ATTY
SEAL
CHECK# 101 1
10131578 ' ,; 264.30
TOTAL AMOUNT PAID:
FiEV-1162. EX(11-96)
$264.30
INITIALS: HMW
RECEIVED BY: GLENDA EARNER STRASRAIIC;H
REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF INDIVIDUAL TAXES
PO BOX 280601
HARRISBURG PA 17128-0601
REV-1543 EX AFP (OB-OB)
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE M0. 21 10-0281
ACN 10131578
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 SWUARE
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 zi 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 of
F'ennsvlvania. Please call 0717) 787-8327 with questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account Balance $ 17 ~ 620.17 payable to "Register of Wills, Agent".
Percent Taxable X 33.333
NOTE: If tax payments are made within three
Amount Subject to Tax $ 5, 873.33 months of the decedent's dzite of death,
Tax Rate X .045 deduct a 5 percent discounl: on the tax due.
Anv Inheritance Tax due will become delinquent
Potential Tax Due $ 264.30 nine months after the date of death.
PART TAXPAYER RESPONSE
Account No. 000031200171164 Date 12-01-1999 To ensure proper credit to the account, two
Established copies of this notice must accompany
payment to the Register of Wills. Make check
1
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
co plete to the best of my knowledge and belief . HOME C iu(.~.. ) 3 1~ ~t ~Cj4~
TAXPAYER SIGNATURE
TELEPHONE NUM
DATE
__
TOTAL CEnter on Line 5 of Tax Computation) ~