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Home My WebLink About10-14-10COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: MILLER DONN JERRE PO BOX 705 DILLSBURG, PA 17019 fold PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ESTATE INFORMATION: sSN: 003-o9-s58o FILE NUMBER: 2110-1029 DECEDENT NAME: MARTEL WILFRED J DATE OF PAYMENT: 10/ 14/2010 POSTMARK DATE: 1 0/ 1 3/2010 COUNTY: CUMBERLAND DATE OF DEATH: 07/31 /2010 ACN ASSESSMENT CONTROL NUMBER AMOUNT 10145025 ~ 575.76 TOTAL AMOUNT PAID: REMARKS: CHECK#1037 SEAL INITIALS: CJ RECEIVED BY 575.76 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REV-1162EX111-96) N0. CD 013494 REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES PO BOX 280601 HARRISBURG PA 17128-0601 _ __ _'.-~ '_' REV 15~~E%'t Ylipl(Rq'~IS)p PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE AND rat.,. ~_-TAXPAYER RESPONSE 4 ~ /~ FILE N0. 21 ~~-~~~~ ACN 10145025 DATE 08-12-2010 2010 OCT ! 4 Phi i ~ 23 CLER~~: CC PATRICIA M MILLER 1011 BRAGGTOWN RD PO BOX 705 DILLSBURG PA 17019 EST. OF WILFRED J MARTEL SSN 003-09-9580 DATE OF DEATH 07-31-2010 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 indicate that at the death of the above-named decedent, you were a point owner/beneficiary of this account. If you feel the information is incorrect, please obtain written correction from the financial institution, attach a coDY 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 Pennsylvania. Please call (717) 787-8327 with questions. cnwPiFTE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 194797-05 Date 06-06-2000 To ensure proper credit to the account, two Established copies of this notice must accompany payment to the Register of Wills. Make check Account Balance ~` 35 ~ 440.24 payable to "Register of Wills, Agent". Percent Taxable X 5.000 NOTE: If tax payments are ^ade within three Amount Subject to Tax $` 1 ~ 772 • 01 months of the decedent's date of death, 045 deduct a 5 percent discount on the tax due. Tax Rate X . Any Inheritance Tax due will become delinquent Potential Tax Due $ 79 • 74 nine months after the date of death. TAXPAYER RESPONSE PART ~LlfR :~T{I $p SILL > ~ ~ UL IN A cOFFi6IAL S~ SENT A. ~ The 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 CHECK Wills and an official assessment will be issued by the PA Department of Revenue. C ONE B L 0 C K B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return 0 N L Y to be filed by the estate representative. C. ~ The above informs ion is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART 3~ below. If indicating a different tax rate, please state ~ ~ ~ `pFFi IAi: USE UNLY~ ~ ~AF PART relationship to decedent: PA D~PAi2TttENt DF REYEf'IUE TRUST ACCOUNTS PAD TAX RE TURN - COMPUTATION OF TAX ON JOINT/ .„__._ . . LINE 1. Date Established 1 } ~~~ ~ 2 2. Account Balance 2 ' X 3 3. Percent Taxable 3 $ 4 4. Amount Subject to Tax 4 ~ 5. Debts and Deductions 5 - ~ $ 6 6. Amount Taxable 6 X 7 7. Tax Rate 7 ~ $ $ 8. Tax Due 8 ~~ ~ PART TAT C D A T T P A Y F E DEBTS AND DEDUCTIONS CLAIMED 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 ~~~ ) S~Z ~//,S ~...,~~ . _ ' - yY) ~L~poh/ WORK C 7/~7 ) 574 '3 ~l7 /O /2 !c~ (.~~'C.{~/.lnQ~~ / ~• TELEPHONE NUMBER DATE ..... .., r`~IATIIDC USA FIRST-CLA55 FOREVER i~~ AO '~ ,f ~~ 'LM - ~~ `~ M''~ 'W }~' j ;p ?"j ,f F,~*, t;~ '~ ~~! .~.~ O'er .~ 9~ ~9 ~ J QQ ~' ,, ~ - .. f ...... W ~ ~ z~io acs ~ ~ ~~ ~= 24 ~'~ ~~1~~ ,, ,.,~. ~ .-,c~.~P, pRPH~~; .~ ~ ..,, a H ~ ~ te ~ `, j r.! tT, ~„ fir, f yam„ v ~7 1~ ` v C:~ t C'° .,.~