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HomeMy WebLinkAbout02-16-11COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: HONOKAUPU CHRISTINA K PO BOX 1337 HAIKU, HI 96708 -------- fold PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ESTATE INFORMATION: SSN: 161-64-9279 FILE NUMBER: 211 1 -0213 DECEDENT NAME: ESTES O S DATE OF PAYMENT: 02/ 16/201 1 POSTMARK DATE: 02/ 1 1 /201 1 COUNTY: CUMBERLAND DATE OF DEATH: 01 /07/201 1 REV-1162 EX~11-96) NO. CD 014025 ACN ASSESSMENT AMOUNT CONTROL NUMBER 1 1 103291 S 16.67 TOTAL AMOUNT PAID: REMARKS: CHECK# 490 SEAL INITIALS: DB S 16.67 RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES PO BOX 280601 [[''TTtt""+^,r,rJ. i-•"; y. HARRISBURG PA 17128-06J6~~., :.` ~ _ - ' ,~ F'`-~ 1 i~ .. 1 R E~-154j EX. AFP .j,(F~88) CHRISTINA PO BOX 1337 HAIKU HI 96708 PENNSYLVANIA INHERITANCE INFORMATION NOTICE AND TAXPAYER RESPONSE TAX FILE N0. 21 - ~,~ _.~~ (4 ACN 11103291 DATE 01-18-2011 EST. OF O S ESTES SSN 161-64-9279 DATE OF DEATH 01-07-2011 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 F CU 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/benefic:iarv 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 INSTP.UCTIONS Account No. 319265-11 Date 12-10-2007 To ensure proper credit to the account, two Established copies of this notice must accompany Payment to the Register of Wi11s. Make check Account Balance 2 340.34 ~ payable to "Register of Wills, Agent". Percent Taxable X 16.667 NOTE: If tax payments are made within three Amount Subject to Tax $ 390.06 months of the decedent's date of death, Tax Rate X ~ 1 rj deduct a 5 percent discount on the tax due. Any Inheritance Tax due will become delinquent Potential Tax Due $` 58 • 51 nine months after the date of death. PART TAXPAYER RESPONSE ~~\~~ ~~~ A~~~~~SNT ~~°~~~~~ I ~T a0~ \ \ ~~~~~~~~ \ ~ . . . . ... , A. ^ The above information and tax due is correct. Remit payment to the Register of Wills with two cop ies 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 Wills and an official assessment will be issued by the PA Department of Revenue. ONE B L 0 C K B. ~ The above asset has been or will be reported and tax pa id 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 IJ below. PART If indicating a different tax to p ase s ~~ ~\~~~~ \\ ~ relationship to decedent: ~ '° '° ~~~ ~ ~' PA DEPARTMENT OF REVENUE TAX RETURN - COMPUTATION OF TA O J jV /TRUST ACCOUNTS PAD ~ ;a ~ ~ Q LINE 1. Date Established 1 j $ ~ ~\ 2. Account Balance 2 2 X V 3. Percent Taxable 3 • 3 4. Amount Subject to Tax 4 $ Q' Cf 5. Debts and Deductions 5 - ~j $ ~ ~ 6. Amount Taxable 6 ' 6 0 ~ 7. Tax Rate 7 X 7 8. Tax Due 8 $ ~~•~S $ PART DEBTS AND DEDUCTIONS CLAIMED 0 DATE PAID PAYEE DESCRIPTI ON AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported aboveaare~ftr(u~e, cor((r~~ect and lete to-the best of my knowledge and belief. HOME C ~Ov) 4~y'~~~V~ N WORK C ) ~~ ~ ~XPAYER SIGNATURE TELEPHONE NUMBER DATE GLEF'~ ~.:'r Or,~'~'1~.~':!'. FJ'~?ART HONOKAUPU TOTAL CEnter on Line 5 of Tax Computation) S ., ~~~Q ~-- P ,<cri=' ~ US 1 ~:? . K'S x,a ~ ,~ !~.w /~'1 ~.• ~ ~.: Y2 ~. F • fjrV ~~~'r^~"SK:y„J i~~ ~"~ ~1 ~~ rt+`' ' r~. t~ti .~ ~`~1 ~~ ;~ rt .+~ r ... r s A A r i w y ~~,. ~,, .. ~ ~ ~; .~~' .. ~, ~' --~ ~ ~ G +rr i ~s ~~ ~ `~i ~ ~' ,~ ~ ~ ~1 ~. 9 ~~ ~ . 6 ~ O, ~~