HomeMy WebLinkAbout12-03-10 (2). ~, yr rENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128.0601
:FINED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
I I 'REV-1762 EX(t t-96)
NO. Qq 013738
LEIBY WANDA G
115 BERNHEISEL BRIDGE R
CARLISLE, PA 17015-9002
- fold
STATE INFORMATION: SSN: 168-26-3436
LE NUMBER: 2110-10$6
ECEDENT NAME: KECK HILDA R
ATE OF PAYMENT: 12/03/2010
~STMARK DATE: 12/02/2010
?UNTY: CUMBERLAND
:TE OF DEATH: 03/15/2010
lIARKS:
ACN
ASSESSMENT
CONTROL
NUMBER
10159554 ~
TOTAL AMOUNT PAID:
)UNT
69.81
S63 ~
CHECK# 0132
INITIALS: SAP
"L RECEIVED BY: GLENDA EARNER STRASBA H
REGISTER OF WILLS ~
REGISTER OF WILLS
PENNSYLVANIA INHERITANCE~rT'~X
INFORMATION NOTICE
BUREAU OF INDIVIDUAL TAXES AND FILE N0. 21--0'~~Dw
PO BOX 280601 y i ; rj~^C ~~TAXPAYER RESPONSE ACN 10159554
HARRISBURG PA 17128-0601
REY-15¢+j~X ~(~}~~+~~ f ~ ~~~ ' ~ DATE 10 - 21- 2 010
ZOIOC~:C -3 PN ~= 3G
CLARK pF
4~''S f~~1~T
CUN~.~R~.l~VO`C``,. ~~.
** WANDA G LEIBY
115 BERNHEISEL BRIDGE R
CARLISLE PA 17015-9002
EST. OF HILDA R KECK
SSN 168-26-3434
DATE OF DEATH 03-15+2b10
COUNTY CUMBERLA~ID~
REMIT PAYMENT AND FORMS Tf~:
REGISTER OF WILLS ''
1 COURTHOUSE SQUARE
CARLISLE PA 17013
TYPE OF ACCOUNT
SAVINGS
® CHECKING
TRUST
CERTIF.
SOVEREIGN BANK provided the Departaent with the inforaation below, which has been used in calculating the
Potential tax due. Records indicate that at the death of the above-naaed decedent, you ware a joint owns /b neficiary of this account.
If you feel the inforaation is incorrect, please obtain written correction free the financial institution, attach a copy to this fora
and return it to the above address. This account is taxable in accortlanee with the Inheritance Tax laws of It he Coaeonwealth of
Pennsylvania. Plosto call C717) 787-8327 with quesiiens.-
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT I~IS~TRUCTIONS
Account No. 1991022174 Date 07-16-2009 To •nsuro proper Icre pit to the account,~ro
Established copies of this n
tic p ^ust accoapany
Account Balance 28 436.08
~ ~
payaent to the R gis
payable to "Regi ter ltar of Wills. Make check
, of Wills, Agent".
Percent Taxable X 50.000
Amount Subject to Tax ~ 14
218
04 WOTEs If tax p aerr ts are wade within three
.
,
aonths of the de ad
nt's dst• of death,
TaX Rate X , 15 deduct a 5 perce t ~ iscount on the tax due.
Potential Tax Dua 39 ~ , ~ *~~ Arai Inheritance ax
~ due will becoae delinquent
Y nine aonths afte tf a date of death.
PART
CHECK
ONE
BLOCK
ONLY
A. ~ Tha above inforaation and tax due is correct.
Reait payrent to the Register of Wills with two copies of this notice~tolobtain
a discount or avoid interest, or chock box "A° and return this notice to'the Register of
Wills and an official assessaent will be issued by the PA Departwant f revenue.
B. ~ Tha above asset has boon or will be reported and tax paid with the
to be filed by the estate representative.
is Inheritance Tax return
C. ~ Tha above infor
ion is incorrect and/or debts and deductions ware paid
m
.
Coaplete PART 2 and/or PART 3 below.
PART 1f indicating a different tax rate, plaasa state
a 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 Taxably 6
7. Tax Rate 7 X
8. Tax Duo 8 ~
PART DEBTS AND DEDUCTIONS CLAIMED
'
neT~ p e7n aevGG TCC/`DTDTT/l-1 aunn~IT n.rn
TOTAL CEnter on Line 5 of Tax Computation) t
Under penalties of perjury, I declare that the facts I have reported above are t
complete to the best of my knowledge and belief.. HOME C T ) ru4,,correct and
~ ~
WORK c ) 1- i- is
TAXPAYER SIG ATU TELEPHON NUMB R DATE
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