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Home My WebLink About11-02-10COMMONWEALTH 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 REV-1162 EXI11-961 NO. CD 013584 FOUTRES DIANE 1 141 COLUMBUS AVE APT 2 LEMOYNE, PA 17043 fold ESTATE INFORMATION: ssN: os1-24-ooss FILE NUMBER: 2110-1087 DECEDENT NAME: DIMOSTENI G KOUMPIAS DATE OF PAYMENT: 1 1 /02/2010 POSTMARK DATE: 1 1 /02/2010 couNTY: CUMBERLAND DATE OF DEATH: 06/09/2010 REMARKS: ACN ASSESSMENT AMOUNT CONTROL NUMBER 10157548 ~ 521.59 10157550 ~ 534.05 TOTAL AMOUNT PAID: 555.64 CHECK# 1341 INITIALS: CJ SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES ~` r ^f +'° ~ ~. AND Po cox zaosol ~-'` ~~``-i~ ~` TAXPAYER RESPONSE HARRISBURG PA 17128-0601 ~. s ~;E i r REV-1543 E% RFP (88-88) FILE N0. 21 -~~ ~ ~~ ACN 10157548 DATE 10-12-2010 2~IQ NOY -2 PN 3~ 09 ~~~~ QF ~~ a co., P~ DIANE -F~rFf-'Fif~- 6349 STEPHENS CROSSING MECHANICSBURG PA 17050 TYPE OF EST. OF DIMOSTENI G KOUMPIAS SSN 081-24-0096 DATE OF DEATH 06-09-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 ACCOUNT SAVINGS ® CHECKING TRUST CERTIF. M & T BANK 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 of Pennsylvania. Please call C717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 9835786725 Date 03-15-2004 To ensure proper credit to the account, two Established copies of this notice ^ust accompany Account Balance 2 879 13 payment to the Register of Wills. Make check " ~ . payable to Register of Wills, Agent". Percent Taxable X 16.667 Amount Subject to Tax $ 479 86 NOTE: If tax payments are made within three . months of the decedent's date of death, Tax Rate ~( .045 deduct a 5 percent discount on the tax due. Potential Tax Due $ 21 • 59 Any Inheritance Tax due will become delinquent nine months after the date of death. P T TAXPAYER RESPONS ~ ~ E AI~:tlRE TO : D. ~tIL1: R N AN OF ~~~'IA,L TJ~C ASS 11EMT. A. I..Yfhe above information and tax due is correct. LJ Remit payment to the Register of Wills with two copies of this notice to obtain C H E C K a discount or avoid i nterest, 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. ONE B L 0 C K B. ~ The above asset has been or wlll 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 incorr ect and/or debts and deductions were paid. Complete PART 2~ and/or ~ PART IJ below. PART If indicating a different tax rate, Please state relationship to decedent: TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Date established 1 2. Account Balance 2 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 5. Debts and Deductions 5 - 6. Amount Taxable 6 $ 7. Tax Rate 7 X 8. Tax Due 8 1 n ::~ ~- 6= . ,. ~- _- PART DEBTS AND DEDUCTIONS CLAIMED ^3 DATE PAID PAYEE DESCRIPTION AMOUNT PAID TOTAL CEnter on Line 5 of Tax Computation) 8 Under penalties of perjury, I declare that the facts I have reported above are tlrue~,r correct and com lete~ to the best f my knowledge and belief. HOME C ~~ ~) (p / ~~ 9'21 Z WORK (~~'7 ) S~.,O - ~ ~F3.3 TAXPAYER SIGNATURE TELEPHONE Nl1MSER m HATE PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE (~ (~ BUREAU OF INDIVIDUAL TAXES AND FILE NO. 21 -~`~ /'"`~ PO BOX 280601 HARRISBURG PA 171zB-o6ol ^.~tj #~, r~~~~~{~/~C.PAYER RESPONSE ACN 710157550 REV-1543 E% 11~t.(~~~87~ ~ ~ i' ~ j:# ~ ~~V1 ~ DATE y Q - 1 2 - 2 0 1 0 ~a~a Hov -2 ~M ~: o~ ^i' ~~'~ LrV~ ~ o `~.~~~RL.~N~ CO , PA DIANE r-".-.rorr T~.S 6349 STEPHENS CROSSING MECHANICSBURG PA 17050 TYPE OF ACCOUNT EST. OF DIMOSTEOI G KOUNPIAS ® SAVINGS SSN 081-24-0096 ~ CHECKING= DATE OF DEATH 06-09-2010 ~ TRUST COUNTY CUMBERLAND ~ CERTIF. REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 M & T BANK 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 Cowwonwealth of Pennsylvania. Please call (717) 787-8327 with questions. - - COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT. INSTRUCTIONS Account No. 15004211212367 Date 06-17-2004 To ensure proper credit to the account, two Established copies of this notice must accowpany Account Balance 4,540.20 payment to the Register of Wills. Make check payable to "Register of Wills, Agent". Percent Taxable X 16.667 NOTE: If tax paywents are made within three Amount Subject to Tax $ 756.72 months of the decedent's date of death, Tax Rate ~( .045 deduct a 5 percent discount on the tax due. Any Inheritance Tax due will become delinquent Potential TeX DUe $ 34.05 nine wonths after the date of death. PART TAXPAYER RESPONSE 1^ ~~,~rR~ to ~,' Lt ~ sUS~T ~zr~ Ax 13FF;IC A1.,rAX. ~s~~ss~e~tT. A. he above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain C H E C K a discount or avoid interest, or check box "A" and return this notice to the Register of C 0 N E ~ Wills and an official assessment will be issued by the PA Department of Revenue. BLOC K B. ~ The above ~ met tia~ been or will be reported and tax paid with the-r.,,nsylvania Inheritance Tax return 0 N L Y to be filed~bv the estate represn~tative. C. ~ The above informs ion is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART 3^ below. PART If indicating a different tax rate, please state relationship to decedent: ~~ ~~ ~ ~q TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS .FAD"' `' " -'.~%~,~ ="'~ LINE 1 . Date Established 1 ~ ~ : - `~„ ,,,,~, yy~,` ,* ~ ~ ~ ~~ 2. Account Balance 2 $ ~ ~'~~ ~~"` ~~'~~" 3. Percent Taxable 3 X 3:° ~ s."~ ~ .,. 4. Amount Subject to Tax 4 $ 4-~, 5. Debts and Deductions 5 (-r. ij ` 6. Amount Taxable 6 d 7. Tax Rate 7 X ~ ~ ~ ~ ''~`"' 8. Tax Due 8 $ 6 '~ '' PART DEBTS AND DEDUCTIONS CLAIMED ^3 DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported abovne are t//rue, correct ~yan~^d1 complete to the best of my knowledge and belief . HOME ~l / ) (p ~ ~~ ~6~'G./ Z~ WORK C~f/ 7 ) .S"~O ~- !d x'33 TAXPAYER SIGNATURE TELEPHONE NUMBER t1ATF TOTAL (Enter on Line 5 of Tax Computation) S -_~.. _, '~ s i it ,X 'yJ S!~ M! ~~ ~y~~,~e «Si. ~I O n r~ Q ~ ~ 0 f 'Y~l•~ ~. . Qq ¢. ~4V~~~ ~ ` ~9Q %~ ~~ ~~ ~~N ~~~Z o~~ ..:: -: ..^, +.~ w .w.. 1 s +w: ~~.. ~.:- b4 P? ..-e t~ ~M vN w ~ ~ v F!