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HomeMy WebLinkAbout03-24-11 (2)COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX111-96) NO. CD 014193 OTT LISA M 1421 BRIDGE STREET NEW CUMBERLAND, PA 17070 -------- fold ACN ASSESSMENT AMOUNT CONTROL NUMBER ---------- -------- ESTATE INFORMATION: SSN: 172-24-9166 FILE NUMBER: 211 1-0395 DECEDENT NAME: OTT WILLIAM R DATE OF PAYMENT: 03/ 25/ 201 1 POSTMARK DATE: 03/23/201 1 COUNTY: CUMBERLAND DATE OF DEATH: 03/07/201 1 11117903 ~ 59.40 TOTAL AMOUNT PAID: REMARKS: SEAL CHECK# 4074 INITIALS: HMW RECEIVED BY: 59.40 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES PO BOX 280601 HARRISBURG PA 17128-0601 _ _ - - PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE ~_:.,~; '- AND `,;; ", ~ AXPAYER RESPONSE ~` REV-1543 EX AFP (OB-08) ~~P~~J~ ~,~~~ Ct1P~~~~E~~~. ~r~~ril ~ ~ '.~ , ~~ LISA M OTT 1421 BRIDGE STREET NEW CUMBERLAND PA 17070 FILE N0. 21 ACN ]L 1117903 DATE q3-17-2011 EST. OF WILLIAM R OTT SSN 172-24-9166 DATE OF DEATH 03-07-2011 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 FCU provided the Department with the information below, which has been used in calculating the t potential tax due. Records indicate that at the death of the above-named decedent, the f . you were a point owner/beneficiary of this accoun financial institution, attach a copy to this form If you feel the information is incorrect, rom please obtain written correction able in accordance with the t t i Inheritance Tax laws of the Commonwealth of and return it to the above address. This ax s accoun Pennsylvania. Please call (717) 787-8327 T 1 BELOW * with questions. SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS COMPLETE PAR Account No . 132985 -11 Date 06 - 11 - 1993 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 $ 435.35 payable to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax payments are made within three Amount Subject to Tax ~` 217 • 68 months of the decedent's date of death, 045 deduct a 5 percent discount on the tax due. Tax Rate )( . Anv Inheritance Tax due will become delinquent Potential Tax Due $ 9 • 80 nine months after the date of death. PART CHECK ONE BLOCK ONLY TAXPAYER ESPONSE FAILURE T© RESPOND WILL RESULT~~IN ~ ~iFfICI~~. TAX ASSESSMENY` A. The above information and tax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain 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. 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 incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART ~ below. PART If indicating a different tax rate, please state OFFjCIAL USE ONLY ~ AAF relationship to decedent: PA DEPARTMENT OF REVENUE TAX RE TURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD LlNt 1. llaLe tsLaollsneo 1 1 2. Account Balance 2 $ 2 3. Percent Taxable 3 X 3 4. Amount Subject to Tax 4 $ 4 5. Debts and Deductions 5 - 5 6. Amount Taxable 6 $ ~ 7. Tax Rate 7 X 7 8. Tax Due 8 $ 8 DEBTS AND DEDUCTIONS CLAIMED PART a neTF porn PAYEE DESCRIPTION AMOUNT PAID Un r penalties of perjury, I declare that the facts I have reported above are true, correct and com ete to the best of my knowledge and belief . HOME C~1(1 ) ~ ~1C`~'d3a ~~ ~, ~ WORK C ER SIGNATURE TELEPHU ~E NUMBER DATE 1DIAL CtnLer On Llne 7 Vr six ~. ~, m~.,u ~a ~iv~~i = ._ ~- _.'1~ ~!- r , ~- M ~`'t ~ _ _4 ~ t h 1; . *~ 1N ry ~ w 4 r fiY 4 G.. N ~ ? r i ~ ~ ~ . ~ ~, ~ ~ ~ ~ , z ~ ^~ ^. a~ ~ ~ v., } ~~ ~ ~b1 ~ { ry,r sQ~itN _. ~ .i ,' t• }~{ ~~ a~ r ~ ~ ~ [ \' ~~{'i V _ i j~~ VV.J ~ `t~g t,> ~ ~ ~ .} ~ ~ ` ..a ~~ ~ ~ ,- ~ ~ ~~ ;r ~~ /'.~ C'- ~-'° N LI1 4? ~~ ~ N ~ . ~ `~' `~, ~ '~