HomeMy WebLinkAbout02-17-11COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1 71 2 8-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1162 EXI11-96)
NO. CD 014027
RASMUSSEN ADIS A
917 FORBES ROAD
CARLISLE, PA 17013
fold
ESTATE INFORMATION: ssrv: 226-a4-2729
FILE NUMBER: 211 1-0214
DECEDENT NAME: GULDEN BARBARA R
DATE OF PAYMENT: 02/ 1 7/201 1
POSTMARK DATE: 02/16/201 1
couNTY: CUMBERLAND
DATE OF DEATH: 12/30/2010
REMARKS:
CHECK# 2127
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
11102840 ~ 551.68
TOTAL AMOUNT PAID:
INITIALS: CJ
551.68
SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
BUREAU OF INDIVIDUAL TAXES AND F I L E
PO BOX 280601 (~(`r`~ TAXPAYER RESPONSE ACN
HARRISBURG PA 17128-0601 ~4 V1.~4 t~
rr; ,{r `~ `i~ ~
~.! k ` ' DATE
1 ~._.}ti.~~`Sidi~ E~~AFP ~(8E -06)r~
N0. 21 ~-(~-a(~
11102840
01-17-2011
'~~ ~ ~E$ { l A~ !i ~ 0~+
CLERK CF
CUi~~R~RI_,~~ti:,J `.rte-. QA
ADIS A RASMUSSEN
917 FORBES ROAD
CARLISLE PA 17013
EST. OF BARBARA R GULDEN
SSN 226-84-2729
DATE OF DEATH 12-30-2010
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 FCU provided the Departsent with the inforsation below, which has been used in calculating the
potential tax due. Records indicate that at the death of the above-nased 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 fors
and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Commorn,ealth of
Pennsylvania. Please call (717? 787-8327 with questions. -
COMPLETE PART 1 BELOW ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 29586-11 Date 05-16-1984
To ensure prover credit to the account, two
Established copies of this notice lust accompany
Account Balance $ 2,296.93 peY•ent to the Register of Wills. Make check
"
payable to
Register of Wills, Agent".
Percent Taxable X 50.000
Amount Subject to TaX $ 1,148.47 NOTE: If tax payments are lade within three
sonths of the decedent's date of death,
Tax Rate ~( .045 deduct a 5 percent discount on the tax due.
Potential Tax Due
51 •68 Any Inheritance Tax due will become delinquent
nine wonths after the date of death.
P~T
1 TAXPAYER RESPONSE
AItU~tE"~ TO SP13NLt~;. WILL <,J7,FilI' ;,Ili},'A~l~ 4FF.ICI~At: T'/IX: A'SS~~1~iT
A. ^ The above information and tax due is correct.
Resit 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
C 0 N E Wills and an official assesssent will be issued by the PA Departwent of Revenue.
~
B L 0 C K
0 N L Y B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
to be filed by the estate representative.
C. ~ The above informs ion is incorr
ect and/or debts and deductions were paid
~
Complete PART 2~ and/or PART IJ below. .
PART If indicating a different tax rate, please state
relationship to decedent:
TAX RETURN - COMPUTATION
LINE I. Date Established
2. Account Balance
3. Percent Taxable
4. Amount Subject to Tax
5. Debts and Deductions
6. Amount Taxable
7. Tax Rate
8. Tax Due
PART
3^
DATE PAID PAYEE
OF TAX ON JOINT/TRUST ACCOUNTS
1
2
3 X
4 +~
5 -
6
7 X
8
~~~~~~
~~' ~~
P,~,1)'
l4 _
~] ', A
.2 ~....~..~.,M-,-
4 }
~.. ~ ~~
DEBTS AND DEDUCTIONS CLAIMED
DESCRIPTION
... [
. ~ A. ~~[
'~'
~ ~.,;,~, r;ir Y, ;
~~
AMOUNT PA7I1
Under penalties of perjury,
comp
e
to the/best o my
le~t I declare that the facts I
knowledge and b
elie
f. have reported above
HOME C are true, correct and
)
/`
~.
`_'
~
R ~
l
~~'~" WORK
TA
YER IGNA
E c~un,(c ,(~unrn
un amine 7 yr lax LOmpULaLlOn) $
r
~ ~o
00
0
v~i a~ ~-
oow-- •Z ~~ ~,
a~-.Jocc~ o _,
atir"~ ~,o
N o~c w¢ ~~
7 U LL
~~~ ++~
-~~ ""ti
-~~ C7
r ...o
~- .-.
-~
•+~:
N
O
Q ~ O ~w
~' •rwr
I
N F '~Iw
J$ w
1 '"~ '
~~
~+
~+4'
ryR
~~i
~r1
"yam
~~
~!¢~!!
^O
l
i~
t1
li
~~
4~~
,,.,~
T...~
' E'•..
,~
i~
r
~ M
~ ~
a l~ii it~~ S,N~t~d~0
~1~31~
~ o ~,
a ,~
`~ '' ` +~ Q ~ i 14~~ L i ~? ~' "0Z
QrnU
s ~ l"'
~. ~i~~~ ~~~~ ~~~~~
3