The URL can be used to link to this page

Home My WebLink About11-23-10 (5)COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT KIRBY CARL D 704 E MARBLE ST MECHANICSBURG, PA 17055-3433 -------- fold ESTATE INFORMATION: ssN: 206-~0-91 ~ 5 FILE NUMBER: 2110-1 160 DECEDENT NAME: KIRBY HELEN B DATE OF PAYMENT: 1 1 / 23/ 2010 POSTMARK DATE: 1 1 /22/201 0 COUNTY: CUMBERLAND DATE OF DEATH: 1 1 /06/2010 REV-1162 EX(11-961 N0. CD 013687 ACN ASSESSMENT AMOUNT CONTROL NUMBER 10166526 ~ $654.31 TOTAL AMOUNT PAID: REMARKS: 5654.31 CHECK# 3633 INITIALS: HMW SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES AND FILE N0. 21 -- ~~ ~ ~ ~~/~ Po sox zso6ol TAXPAYER RESPONSE ACN lO1b6526 HARRISBURG PA 17128-0601 DATE 11-22.-2010 CARL D KIRBY 704 E MARBLE ST MECHANICSBURG PA 17055 EST. OF HELEN B KIF:BY SSN 206-10-9115 DATE OF DEATH 11-06-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS To: 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 (717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 360869-41 Date 07-02-2009 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 $` 30 ~ b 1 0 • b 1 payable to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax payments are made within three Amount Subject to Tax $ 15, 305.31 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 Tax Due $ b$8.74 nine months after the date of death. PART TAXPAYER RESPONSE A T~.. ~~ ~#~ W I LPL R E_ ,, T' I N A~1 F fi~~~ TAX A S 5f S S~4N T A. he 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 C H E C K Wills and an official assessment will be issued by the PA Department of Revenue. ONE BLOC K B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tay: return O 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 3LJ below. PART If indicating a different tax rate, please state OFFIC,' L USE ONLY` ~ AAF ~ ~~ a relationship to decedent: ~ \~ ~T OF AVENUE PA DEP TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS ~ PAD ~` '~ \~` 1 1 ~ ~ \\ LINE 1. Date Established ~ ~ 2. Account Balance 2 $ 2 ~ ~ ~~~ \ \ 3 X 3 \ ~~ \\ \~ 3. Percent Taxable \~\ \\\~ \ r` \ 4. Amount Subject to Tax 4 $ 4 ~ ~ \\\\\~ \ \\\\ \\ ~~ \ 5. Debts and Deductions 5 - 5 „ 6. Amount Taxable 6 $ b \~ ~ N 7. Tax Rate 7 X 7 ~:~ 8. Tax Due 8 $ ~~ ~ $ PART DEBTS AND DEDUCTIONS CLAIMED a DATE PAID PAYEE DESCRIPTION AMOUNT PAI D Under_ penalties of perjury, I declare that the facts I c~iipl~te to the bet o m knowledge and belief. have reported HOME above are true, c,/orrect and (~7/~i ) ~~'~' ~"/..~'~~ ~~ j '~,) ~. ~ WORK ( .""~ ~ ~ ~,.< -~ cal /~i~ PAYE SIGNATU E TELEPHONE NUMBER ATE TOTAL (Enter on Line 5 of Tax Computation) S ~ c~ __ ~ ~ i~ , ... . ~ . . 2U' ~ ~~~~` 23 PSI 12~ Q5 ~t_~~~'r. ~i ~F 1tt"--~' N~ Est i ~~. ~ ~. `~. ~ e~ ~°t ~ r ~• ~ c ` ~. ~. ~ ~~ ~! ~~ {`~`'~\ O '~ 1`...7 `~. ,.~ ~. W ~Y . ~a ~. C~~"~ ~r.~ `~_ ~~ ;~' ~~ ~ .,` 7 ~( -.`}1, i T~ .~ ~1, .~~'' -j ~`i .~ ,~ ~~ 3 r~.~ ~ ~f •~h ~; ,.*~~ t~; ,,y "~.j ,. ~ ~ ; tJ~: '~.~ '. w', 'prt'~ `~:wr~~ :,,~ $ I,f i ~-~ <~. : Y'•. ~:~ ~' lT! ;~ "'~ ,r:~, 1' I 213~321q~ SSNl}15211! t+5f1 ~'