HomeMy WebLinkAbout03-21-11COMMON'dVEALTH Of= FENNSYI_\','~'.Ir\
DEPARTMENT OF RE\iEfJUE
BUREAU OF INDIVIDUAL. TAXES
DEPT. 7.80601
HARRISBURG, PA 1 7 1 28-0601
RECEIVED FROM:
BURWELL RONAI_.D J
19 PARK DRIVE
DILLSBURG, PA 17019
-------- fold
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
FEV-'1'162 EXI11-96)
N0. CD (J 14154
AC:N
ASSESSMENT AMOUNT
CONTROL
NUMBER
ESTATE INFORMATION; SsN: 086-26-9409
FILE NUMBER: 21 1 1 -01 55
DECEDENT NAME: BURWELL JOYCE N
DATE OF PAYMENT: 03/ 21 / 201 1
POSTMARK DATE: 03/ 1 8/201 1
COUNTY': CUMBERLAND
DATE OF DEATH: 1 2/ 30/ 201 0
11115896 ~ $9.~~7
TOTAL AMOUNT PAID:
REMARKS:
SEAL
CHECK# 1688
,~9.~7
INITIALS: HMW
RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF INDIVIDUAL TARES -
PO BOX 280601
HARRISBURG PA 17128-060f
;.; ..
,,
FILE NO»21 11-0155
ACN 11115896
DATE 03-08-2011
RONALD J BURWELL
19 PARK DR
DILLSBURG PA 17019-1383
EST. OF JOYCE N BURWELL
SSN 08b-26-9409
DATE OF DEATH 12-30-2010
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHIDUSE SQUARE
CARLISLE PA 17013
Tti'PE OF ACCOUNT
SAVINGS
CHECKING
TRUST
CERTIF.
PNC BANK NA provided the Department with the information t~elow, 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 -Fax laws of the Connmonwealth of
Pennsvlvan9.a. Please call (717) 787-8327 with auast;nns.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUC:'fIONS
Account No. 500:3547936 Date 04-03-2008 To ensure proper credit to the account, two
Established copiies of this notice muss: accompany
ACCOUnt Ba:LanCe 421.08 payment t:o the Register of Wills. Make check
$ payable t:o "Register of riiills, Agent".
Percent Taxable X 50.000
Amount Subject to Tax NOME: If' tax payments are made within three
$ 210.54
moni:hs of the decedent"s date of death,
Tax Rate X . 045 deduct a 5 percent discount on t:he tax due.
Potential lax Due Any Inheritance Tax due will become delinquent
$ 9.47 nine months after the date of death.
PART
FAiI.URE TAXPAYER RESPONSE
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
0 N E a discount or avoid interest, or check box "A" and return this notice to the IZegi:>ter of
Wills and an official assessment will be issued by the PA Department of Revenu~a..
BLOC 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.
f: ~ The above information is incorrect and/or debts and deductions were paid.
Complete PART 2~ and/or PART L__J below.
PART It indicating a different tax rate, please state
relationship t0 decedent:
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
LINE 1. Date Established 1
2. Account Balance 2 $
3. Percent Taxable 3 X
~+. Amount Subject to Tax 4 $
5. Debts and Deductions 5 -
6. Amount Taxable 6 $
7. Tax Rat.=_ 7 X
8. Tax Due g $
PART
DATE PAID PAYEE
PAD
1
2
3
4
5
6
7
8
DEBTS AND DEDUCTIONS CLAIMED
DESCRIPTION
AMOUNT PAID
Under penalties
co a to the
of perjury, I declare that the facts I
e_, of my knowledge and belief. ----
have reported above are true, correct and
HOME ~~) Z '---~~ ~~ ~ ~ ~-
~L..,I;,~.
....
TA AYER S GN IIRE TELEPHONE NUMBER DATE
PENNSYLVANIA INHERITANCE TAX
_ _ INFORMATION NOITICE
AND
- TAXPAYER RESPONSE
REV-154' H-n8?
OFFICIAL USE ONLY [~ AAF
PA DEPARTMENT OF REVENUE
IUIHL ~tnLer on Line ~ of Tax Computation) S
~;,
(`~ {''
`...~
~ ~ ~~
~~ ~
• ~'
-~ .
---- '~
Q
c
° ~'~
c
~~
~ c `^
a
W