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Home My WebLink About04-15-11 (2)COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT SHEEHAN C A 206 S WEST STREET CARLISLE, PA 17013 ACN ASSESSMENT CONTROL NUMBER -------- fold ESTATE INFORMATION: SSN: 098-14-8806 FILE NUMBER: 211 1-0484 DECEDENT NAME: SHEEHAN CHARLOTTE A DATE OF PAYMENT: 04/ 15/201 1 POSTMARK DATE: 04/ 15/201 1 COUNTY: CUMBERLAND DATE OF DEATH: 1 1 /27/2010 REMARKS: C ANN SHEEHAN SEAL CHECK# 4125 AMOUNT 11118813 ~ $31.04 I TOTAL AMOUNT PAID: INITIALS: WZ RECEIVED BY: $31.04 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS REV-1162 EX(11-96) NO. CD 014313 PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES A N D Po Box 2so6o1 TAXPAYER RESPONSE HARRISBURG PA 17128-0601 ~;,( F ~ ~ ~.~-~.- ~,- f_.<<.~ i ~ r_ ~,;~ ~,~`" REVISED NOTICE * ~ REV-1543 E ~ ;--(U8-B&~ ~ ~ ~ ~ ,~ ', .. ; i . ~..' J _i ;~ EST. OF CHARLOTTE A SHEEHAN SSN 098-14-8806 DATE OF DEATH :11-27-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 C~E~~ ~~ C~R~_~~N'S C,~vRT JONATHAN S DRAKE ~~~~`~~'~~~-~~~`~~-~' ~~ . ~aA, 5933 WILLIAMSBURG RD ALEXANDRIA VA 22303 TYPE OF ACCOUNT SAVINGS ® CHECKING TRUST CERTIF. WA CHOVIA BK NA 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/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 Tax laws of the Commonwealth of Pennsylvania. Please call (717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 1040000387203 Date 07-01-1997 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance 4 ~ 137.95 Payment to the Register of Wills. Make check $ payable to "Register of Wills, Agent". Percent Taxable X 16.667 NOTE: If tax payments are made within three Amount Subject to Tax $ 6$9.67 months of the decedent's date of death, Tax Rate X .045 deduct a 5. percent discount on the tax due. Anv Inheritance Tax due will become delinquent Potential Tax Due $ 31 .04 nine months after the date of death. PART TAXPAYER RESPONSE ^ ~~ ,~ ~\ 0 ~ . ~ ` 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 Wills and an official assessment will be issued by the PA Depai°tment of Revenue. ONE 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. C. ~ The above informs ion is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART 3~ below. 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 1 ~ ~" ` 2. Account Balance 2 $ \ \~ 3. Percent Taxable 3 X \ \~ ~ e m\ 4. Amount Subject to Tax 4 $ \~ 5. Debts and Deductions 5 - \ \~ ` 6. Amount Taxable 6 $ \ \~ ~ ~~~\ 7. Tax Rate 7 X 8. Tax Due 8 PART DEBTS AND DEDUCTIONS CLAIMED 0 DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported above .are ~rnue, c~ojrrect andOO~~/- complete to the best o my k edge and belief. HOME ) `~ p~ ( go~w WORK C ~) ~ d~~ 1 "ZD~1 TAXP ER SIGNATURE TELEPHONE NUMBER DATE FILE N0. 21--~~ f -~~~~ ACN 11118812 DATE 03-29-2011 TOTAL (Enter on Line 5 of Tax Computation) $