The URL can be used to link to this page

Home My WebLink About11-23-10 (4)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 REV-1162 E.X(11-96) NO. CD 013688 CARL D KIRBY 704 E MARBLE ST MECHANICSBURG, PA 17055-3433 -------- fold ESTATE INFORMATION: SSN: 206-10-9115 FILE NUMBER: 2110-1 160 DECEDENT NAME: KIRBY HELEN B DATE OF PAYMENT: 1 1 / 23/ 2010 POSTMARK DATE: 1 1 /22/2010 COUNTY: CUMBERLAND DATE OF DEATH: 1 1 /06/2010 REMARKS: ACN ASSESSMENT AMOUNT CONTROL NUMBER 10166528 ~ $1,088.04 TOTAL AMOUNT PAID: $1,088.04 CHECK# 3631 INITIALS: HMW SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH' REGISTER OF WILLS REGISTER OF WILLS PENNSYLVANIA INHERITANCE TAX INFORMATION NOT:[CE BUREAU OF INDIVIDUAL TAXES A N D Po Box 280601 TAXPAYER RESPONSE HARRISBURG PA 17128-0601 REV-1543 EX AFP (88-08) FILE N0. 21''' ~~~- ~~~~ ACN 10166528 DATE 11-22-2010 CARL D KIRBY 704 E MARBLE ST MECHANICSBURG PA 17055 EST. OF HELEN B KIRBY SSN 206-10-9115 DATE OF DEATH 11-06-2010 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/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. 360869-44 Date 07-02-2009 To ensure proper credit to the account:, two Established copies of this notice must accompany Account Balance 50 902.41 payment to the Register of Wills. Make check ~ payable to Register of Wills, Agent . Percent Taxable X 50.000 NOTE: If tax payments are made within three Amount Subject to Tax $ 25, 451.21 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 will become delinquent Potential Tax Due ~ 1 , 145.30 nine months after the date of death. PART TAXPAYER RESPONSE 1 FAI~L20, ~Sd"``W1`° . ~5.~.....~N A~1 ~FFICiAL TA~C,ASS~SSME~IT ~~~ 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 0 N E Wills and an official assessment will be issued by the PA Department of Revenue. 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 Complete PART ~2 ion is incorrect and/or and/or PART ~ below. debts and deductions were paid. fti~ PART If indicating a different tax rate, please state 2 relationship to decedent: ` ~ PA DEP T . TAX RE TURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD LINE 1. Date Established 1 1 ~ ~~~ ~~ 2. Account Balance 2 $ 2 .. CrJ ?\:. 3. Percent Taxable 3 X 3 ~Z~ \ "~ ~O\ 4. Amount Subject to Tax 4 (i ~ ~ ~ :.. ~. 5. Debts and Deductions 5 - 5 ~ ~ ~~ x- N c .° ' ( 6. Amount Taxable b $ ~ ~ w,\~' 7. Tax Rate 7 X 7 4 ~~" 8. Tax Due 8 +fi g PART DEBTS AND DEDUCTIONS CLAIMED DATE P AID PAYEE DESCRIPTION A MOUNT PAID Under penalties of perjury, I declare that the facts I ~niplete to the be~5t my knowledge and belief. ~~ < have reported above HOME C 7 • are true, correct and ~ 7 - ° ~~-~ ~~ W O R K ( ~ ~ J~ •- ,~~ • _ -C1 ~C~ ~XPAYER SIG URE TELEPHON NUMBER DATE TOTAL CEnter on Line 5 of Tax Computation) $ ., '10 }dfl~ ~~~ ~~"~3~ ~~ ~ ~~ ~LE~:~ - .:~PNAN'S ~~ ~. ~' ~ ~. ....~ ~; h 9 tAf ` j~ ~R~ v e~ {~ `~~,~ ~'`~\~ "~R-.y ~"~"' :.. i r~r w __ ~J ~ 1 _ ~, w .r,. :~ «w `~*` ~ r` ~~('"~•_ V l s ~~ ~'~ ~`_", '~5... •' ~.-~~- ~.~ ~ ~ ,~ ~ ~~ ~,,~. w ~ r' ~ ~ ~ L .. ~~, ,; ~~ <-~ P;, xr ~'~ ~,~ ~~ ~: ~! ', k~s '~ ~. i `d)` si. . ~" ~ ~# t,;, t ~~ ~ r ~,~ ,~ i ~` '~`_, ~ 3 ~Y ' E- i~ .. }~ fir y~;y`r ~~~ ~~ ~z% ~~ x. '~ ~x i.~~~ C~ ~ ..~4 ~ .~. f` z 310 SS lJ„~ '~ NSt1 w} ~fp ~ s~ ~