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Home My WebLink About02-17-11COMMQNWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT LUCY DEBORAH A 533 GOOD HOPE ROAD MECHANICSBURG, PA 17050 -------- fold REV-1162 EX111-96) NO. CD 014028 ACN ASSESSMENT AMOUNT CONTROL NUMBER ESTATE INFORMATION: ssrv: ~ s3-i 2-4098 FILE NUMBER: 21 1 1 -021 5 DECEDENT NAME: KAUTZ PETER A DATE OF PAYMENT: 02/ 1 7/201 1 POSTMARK DATE: 02/17/201 1 COUNTY: CUMBERLAND DATE OF DEATH : 09/ 28/ 201 0 REMARKS: SEAL CHECK# 1013 10159391 ~ $1 17.22 10159413 ~ $316.50 TOTAL AMOUNT PAID: INITIALS: HMW RECEIVED BY: X433.72 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES A N D Po Box 280601 TAXPAYER RESPONSE HARRISBURG PA 17128-0601 REV-1543 EX AFP (08-08) FILE NO. 21 ACN 10159391 DATE 10-19-2010 DEBORAH LUCY 124 WOODS DR LOT 9A MECHANICSBURG PA 17050 EST. OF PETER A KAUTZ SSN 183-12-4098 DATE OF DEATH 09-28-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FDRMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. MID PENN BK 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 ral:i (717) 787-837 with c,~~e~tiens. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 309002456 Date 02-17-2009 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 $ 5, 209 . 7b payable to "Register of Wills„ Agent". Percent Taxable X 50.000 NOTE: If tax payments are made within three Amount Subject to Tax $ 2, b04 . 88 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 t~ecome delinquent Potential Tax Due $ 117.22 nine months after the date of death. PART TAXPAYER RESPONSE ~ FAILURE TO RESPOND WILT RESULT IN AN OF`FICIAE 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 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 OFFICIAL USE ONLY ~ AAF relationship to decedent: PA DEPARTMENT OF REVENUE ~, _ ; TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS pqp f:_~- L1NE 1. Hate Established 1 ~ --- -..~--, ~~ 1 n _ ~J__ "'T_ r r -~ ~'~i 2. Account Balance 2 $ 2 :~.~1 ~ ~ ,----, ; ~~ 3. Percent Taxable 3 X 3 __ ~7~ f"` _ ~-." % ~-' - 4. Amount Subject to Tax 4 $ ~ r':' ~• ~-~ -. -.....i ._ ~~•.. 5. Debts and Deductions 5 - 5 - -, ~` 6. Amount Taxable 6 b T ~ "'- 7. Tax Rate 7 X 7 ~ Vii. : - ,`: 1 8. T a x D u e 8 ~` 8 _D r..., ~~ ~ 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. H 0 M E C ) WORK C ) TAXPAYER SIGNATURE TELEPHONE NUMBER DATE IUTAL ltnLer On L1ne 5 of Tax Computation) S PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES A N D Po Box 280601 ~~ TAXPAYER RESPONSE HARRISBURG PA 17128-0601 REV-1543 EX AFP (OB-08) FILE N0. 21 ACN 10159413 DATE 10-20-2010 ~~ DEBORAH LUCY 124 WOODS DR LOT 9A MECHANICSBURG PA 17050 EST. OF PETER A KAUTZ SSN 183-12-4098 DATE OF DEATH 09-28-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SgUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. MID PENN BK 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 Pe~)nsylvan~a. Please tali :717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 309002948 Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due Date 06-15-2010 Established $ 7,033.40 X 100.00 $ 7,033.40 X .045 316.50 To ensure proper credit to the account, two copies of this notice must accompany payment to the Register of Wills. Make check payable to "Register of Wills, Agent". NOTE: If tax payments are made within three months of the decedent's date of death, deduct a 5 percent discount one the tax due. Any Inheritance Tax due will become delinquent nine months after the date of death. PART TAXPAYER RESPONSE FAILURE TO RESPOND WILL RESULT 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 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 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 Taxable 6 7. Tax Rate 7 X 8. Tax Due 8 t1F~L US~~ONL1 AAF PA DE f NT ~t RE~~11 PAD ~~._-r-- ~~ ;,~, ~~ a 2 `~ -- ~~~ ~ ,.~~ 5 ~ ~ ~. 7 6 ~ ~~ 7 PART DEBTS AND DEDUCTIONS CLAIMED a 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. H 0 ME C ) WORK C TAXPAYER SIGNATURE TELEPHONE NUMBER DATE TOTAL CEnter on Line 5 of Tax Computation) $