HomeMy WebLinkAbout03-08-11 (2)COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 014094
MEAD JAMES M
1752 CONWAY HEATH
CAMP HILL, PA 1701 1
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ESTATE INFORMATION: SSN: 193-01-2449
FILE NUMBER: 211 1-0308
DECEDENT NAME: MEAD JAMES L
DATE OF PAYMENT: 03/08/201 1
POSTMARK DATE: 03/07/201 1
COUNTY: CUMBERLAND
DATE OF DEATH: 01 / 13/201 1
REMARKS:
ACN
ASSESSMENT
CONTROL
NUMBER
REV-1162 EX111-96)
AMOUNT
1 1 1 13146 ~ $810.54
I
TOTAL AMOUNT PAID:
5810.54
CHECK# 354
INITIALS: DB
SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF INDIVIDUAL TAXES
PO BOX 280601 ~~}}_~_ ~ , r. ••~ - ~ -° ~ ~,
HARRISBURG PA 17128-06~~_`..;~~.. '~~
-.r it i t^,
,., ~~!! •... REV-1543 EX~AFP- (088)
C. ~ The above informs ion is incorrect and/or debts and deductions were paid.
Complete PART 2~ and/or PART 3~ below.
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JAMES M MEADE
1752 CONWAY HEATH
CAMP HILL PA 17011
FILE N0. 21 r- I I -U`~C~`~
ACN 11113146
DATE 02-25-2011
TYPE OF ACCOUNT
SAVINGS
CHECKING
TRUST
a CERTIF.
METRO BANK provided the Department with the information below, which has been used in calculating the
potential tax due. Records indicate that at the death
f th
o
e above-named decedent,
If you feel the information is incorrect, please obtain written corr
ti you were a joint owner/beneficiary of this account.
ec
on from the
and return it to the above address. This account is taxable in accordance with the
Pennsylv
i
P financial institution, attach a copy to this form
Inheritance Tax l
f
an
a.
lease call C717) 787-8327 with questions. aws o
the Commonwealth of
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 120001662 Date 07-23-2008
Established To ensure proper credit to the account, two
Account Balance ~- 10,$07.14 copies of this notice must accompany
payment to the Register of Wills. Make check
Percent Taxable X payable to "Register of Wills, Agent".
50.000
Amount Subject to Tax $ 5, 403.57 NOTE: If tax payments are made within three
Tax Rate ~( months of the decedent's date of death,
~ lj deduct a 5 percent discount on the tax due
Potential Tax Due $- $10.54 .
Any Inheritance Tax due will become delinquent
PART nine months after the date of death.
TAXPAYER RESPONSE
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.
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 I
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 ~ )(
8. Tax Due g $
PART
0
DATE PAID
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
DEBTS AND DEDUCTTnNC f ~ e r61rn
PAYEE
DESCRIPTION
AMOUNT PAID
TOTAL (Enter on Line 5 of Tax Computation) $
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.
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T X ER SIGNATURE TELEPHONE NUMBER
- DATE
EST. OF JAMES L MEAD
SSN 193-01-2449
DATE OF DEATH 01-13-2011
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
PA DE
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