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Home My WebLink About11-08-10COMMONWEALTH 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 EX(11-96) N0. CD 013612 SCHIESSL HENRY W 145 TOWER CIRCLE CARLISLE, PA 17013-9627 ACN ASSESSMENT CONTROL NUMBER -------- fold ESTATE INFORMATION: SSN: 397-26-1194 FILE NUMBER: 21 10-1 1 10 DECEDENT NAME: SCHIESSL DANIEL M DATE OF PAYMENT: 1 1 /08/2010 POSTMARK DATE: 1 1 /06/201 0 CouNTY: CUMBERLAND DATE OF DEATH: 10/ 12/201 0 REMARKS: SEAL CHECK#2630 AMOUNT 10159867 ~ $4.98 TOTAL AMOUNT PAID: $4.98 INITIALS: HMW RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES A N D Po Box zao6ol ~ TAXPAYER RESPONSE HARRISBURG PA 17128-0601 REV-1543 EX AFP (08-08) FILE_ N0. 21 -1Q - 1/r~`y ACN 10159867 DATE: 10-22-2010 HENRY W SCHIESSL 145 TOWER CIRCLE CARLISLE PA 17013 EST. OF DANIEL M SCHIESSL SSN 397-26-1194 DATE OF DEATH 10-12-2010 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 joint owner/benefic:iary 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 Pennsvlvania. Please call (7171 7R7-8;27 W;tt? ~!~es±ions~ COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No . 31627 - 11 Date 09 - 01-1985 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance 664.55 payment to the Register of Wills. Make check payable to "Register of Wills, Agent". Percent Taxable X 16.667 NOTE: If tax payments are made within three Amount Subject to Tax ~` 110.76 months of the decedent's date of death, Tax Rate X .045 deduct a 5 percent discount on the tax due. Any Inheritance Tax due wi]'-1 become delinquent Potential Tax Due $ 4 • 98 nine months after the date of death. PART TAXPAYER RESPONSE FAILURE TO RESPUNU WILL RE5U1"T IN AN OFFICIAL TAX ASSESSMENT A. ~ The 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 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 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 ~ below. PART If indicating a different tax rate, please state OFFICIAL USE ONLY ~ AAF relationship to decedent: PA DEPARTMENT OF REVENUE TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD LINE 1. Date Established 1 1 - c~ -~.- 2 . Account Balance 2 $ 2 ~ ~ --- t 1~,,~. -r._ ~. ._ 3. Percent Taxable 3 X 3 Q ~ ~' 4. Amount Subject to lax 4 4 L F.;`~ .t' 5. Debts and Deductions 5 ~ ,~'~' -'~ ~ 6. Amount Taxable 6 $ 6 F~~~~~~`~~"~_~ ~~ 7. Tax Rate 7 - 8. Tax Due 8 $ $ ~ ~ - PART DEBTS AND DEDUCTIONS CLAIMED -~' ,~ x 0 DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported above are true, corr~e`ct: and comPl to to tt~e b t f Amy know edge and belief . HOME C'~ / 7 ~ ~~~ -- ~ 3 f G~ WORK c ~ ~~ ~ ~r TAX AYER IGNATURE TELEPHONE NUMBER DATE TOTAL (Enter on Line 5 of Tax Computation) $ HANK SCHIESSL 145 TOWER CIRCLE CARLISLE, PA 17013 -- - -- - - - --------a......._- _ ~.-- ~' r ~.,~`"^w.~..~ gym' ~~ N did nr~~w ate'' < p ff ~~~~ qq qq,, , f. ~it. ~' S~ ~ `4. .~.~ ~S~.S.:1 ~ ~ ~. ±~R i}~ ~-.: wN-"~4a~,~ 7"' ~..:aa°.3~. w+vra~w~+rw _ ~~ . r.., -.., , ~~- !~ 13~~~J;~.:1 _-~:1~. ~~~ _~-~ r~.ttr:3:ltll~~~,:~ttE,t~,tqtr=.,li~~,~~t"t~tr{I„lfl,~t~tl~i ~~ ~` ~ ~ ~ ~fZ~ ~ '~ 1