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HomeMy WebLinkAbout02-10-11COMMONWEALTH 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 BARYON GLORIA B 622 THRUSH CT MECHANICSBURG, PA 17050 -------- fold ESTATE INFORMATION: ssrv: 065-as-31 ~ 3 FILE NUMBER: 21 1 1 -0179 DECEDENT NAME: BARYON JAMES F SR DATE OF PAYMENT: 02/ 10/201 1 POSTMARK DATE: 02/09/201 1 CouNTY: CUMBERLAND DATE OF DEATH: 1 1 /24/201 0 FiEV'-1162 EX(11-96) NO. CD 014006 ACN ASSESSMENT AMOUNT CONTROL NUMBER 11106044 ~ $36.42 TOTAL AMOUNT PAID: REMARKS: CHECK# 1362 SEAL INITIALS: DB 536.42 RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES PO BOX 280601 HARRISBURG PA 17128-0601 i3 .EX AFP"~(OB-OS'> '~3 PENNSYLVANIA INHERITANCE INFORMATION NOTICE AND '~~~ ~ TAXPAYER RESPONSE TAX F I L E N 0 . 21 -~ ~ ~ - (;~ ~ ~ ACN 11106044 DATE 02-02-2011 r i• ~,,~ MICHAEL J WHITSEL 529 QUAIL CT MECHANICSBURG PA 17050 ~A ~ E5 siP.. EST. OF ~ F BARYON SSN 065-38-3113 DATE OF DEATH 11-24-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING a TRUST CERTIF. M 8, 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 ]oint owner/benefir.iary of this account. It 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. 15004212420191 Date 11-04-2005 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance 1 ~ b 18.70 payment to the Register of 'Wills. Make check payable to "Register of Walls, Agent". Percent Taxable X 50.000 NOTE: If tax payments are made within three AmOUnt Subject to Tax $ 809.35 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 wall become delinquent Potential Tax Due $ 36.42 nine months after the date of death. PART TAXPAYER RESPONSE ~ FAILED TO RESPOND WILL RESULT I~N AN ©FFICIAL TAX ASSESS1dENT 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 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 QFFI..CjAL 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 2. Account Balance 2 $ 2 3. Percent Taxable 3 X 3 4. Amount Subject to Tax 4 $ 4 5. Debts and Deductions 5 - 5 6. Amount Taxable 6 $ 6 7. Tax Rate 7 X 7 8. Tax Due 8 $ $ PART DEBTS AND DEDUCTIONS CLAIMED ^3 DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported above are true, correct and complete to the best of my knowledge and belief . HOME C ~ ~ ~ ) 7CjD-- i~~ ;~ ,~ ~.. ,~ WORK t •~/ ~ ~ 7G~ 6.~~f~ ,XPAYER SIGNATURE TELEPHONE NUMBER DATE TOTAL CEnter on Line 5 of Tax Computation) ~