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HomeMy WebLinkAbout04-26-11COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 2 8-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 014360 MCMASTERS LINDSAY D 108 DEODATE ROAD MIDDLETOWN, PA 17057 told ESTATE INFORMATION: ssrv: 208-as-5500 FILE NUMBER: 211 1-0203 DECEDENT NAME: STEVENS CARRIE R COULSON DATE OF PAYMENT: 04/26/201 1 POSTMARK DATE: 04/25/201 1 COUNTY: CUMBERLAND DATE OF DEATH: 01 /26/201 1 REMARKS: CHECK#106 SEAL ACN ASSESSMENT AMOUNT CONTROL NUMBER 11500865 ~ 5947.77 TOTAL AMOUNT PAID: INITIALS: CJ REV-1162 EXI11-96) 5947.77 RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES PO BOX 280601 HARRISBURG PA 17128-0601 ~} F ~~ l ; 1; l C I'.., REV.-1543k AF-'Y7~00) INFORMATION NOTICE AND TAXPAYER RESPONSE FILE N0. 21 11-0203 ACN 11500865 DATE 04-21-2011 r, ,~„ . Ct~ERK OF OR°H~N'S L~~LR 1 LINDSAY D MCMASTERS 108 NORTH DEODATE ROAD MIDDLETOWN PA 17057 TYPE OF ACCOUNT EST. OF CARRIE R STEVENS ^ SECURITY S.S. N0. 208-38-5500 ~ SEC ACCT DATE OF DEATH O 1 - 26 - 2011 ^ srocK COUNTY CUMBERLAND ^ BoNDs REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 FIDELITY has provided the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a beneficiary of this asset. If you feel this information is incorrect, please obtain written correction from the transfer agent, 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. questions may be answered by calling (717) 787-8327. COMPLETE PART 1 BELOW * * * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS AccOUnt No. 73116 To insure proper credit to your account, two C2) copies of this notice must accompany your payment to the Register of Wills. Make check DOD Valuation 6,b50.87 payable to: "Register of Wills, Agent". Percent Taxable X 100.00 NOTE: If tax payments are made within three Amount Subject to Tax 6,650.87 (3) months of the decedent's date of death, Tax Rate X 15 you may deduct a 5% discount of the tax due. Any inheritance tax due will become delinquent Potential Tax Due 997.63 nine (9) months after the date of death. P~T TAXPAYER RESPONSE 1 - FAILUJiE TO RESPOND WILL RESULT IN Ali OFFICIAL~~A;X ASSESSMENT BASED Off! THIS NOTICE A. The above information and tax due is correct. You may choose to remit payment to the Register of Wills with two copies of this notice to obtain CHECK a discount or avoid interest, or you may 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 decedent's representative. C. ^ The above information is incorrect and/or debts and deductions were paid by you. You oust complete PART ~ and/or PART ~ below. PART If you indicate a different tax rate, please state your OFFICIAL USE ONLY ^ AAF relationship to decedent: PA DEPARTMENT OF REVENUE TAX RETURN - COMPUTATION OF TAX ON ABOVE ASSETCS) PAD __ _ _ __ LINE I. DOD Valuation 1 1 2. Percent Taxable 2 X 2 3. Amount Subject to Tax 3 3 4. Debts and Deductions 4 - C+ 5. Amount Taxable 5 5 6. Tax Rate 6 X 6 7. Tax Due 7 7 8 PART DEBTS AND DEDUCTIONS CLAIMED 3^ DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported above are true, correct and om ~~ ~th bes of my wiedge and belief. HOME C ) ~ WORK C ) Z ' r vow o crruwTnor rte, ~.,......~ ........~.. ____ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES PD BOX 280601 HARRISBURG PA 17128-D601 f ~~^,~ ~,- I~EV 1~,G 3A AFP (7-00) ~'••' INFORMATION NOTICE FILE N0. 21 11-0203 AND ACN 11500865 ~~TAXPAYER RESPONSE ~ DATE 04-21-2011 C~~~~ n~ LINDSAY D MCMASTERS (~~IM~''-~~-~~~~~~'' "l ~ ~~ 108 NORTH DEODATE ROAD MIDDLETOWN PA 17057 TYPE OF ACCOUNT EST. OF CARRIE R STEVENS ^ SECURITY S.S. N0. 208-38-5500 X^ sEC ACCT DATE OF DEATH 01-26-2011 ^ STOCK COUNTY CUMBERLAND ^ BoNDs REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 FIDELITY has provided the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a beneficiary of this asset. If you feel this information is incorrect, please obtain written correction from the transfer agent, 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. Questions may be answered by calling (717) 787-8327. COMPLETE PART 1 BELOW * * * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 73116 To insure proper credit to your account, two (2) copies of this notice must accompany your 6 5 0 .8 7 payment to the Register of Wills. Make check DOD Valuation 6 ~ payable to: "Register of Wills, Agent". Percent Taxable X 100.00 NOTE: If tax payments are made within three Amount Subject to Tax 6, 650.87 C3) months of the decedent's date of death, Tax Rate X 15 you may deduct a 5% discount of the tax due. Any inheritance tax due will become delinquent Potential Tax Due 997.63 nine (9) months after the date of death. PART TAXPAYER RESPONSE ^~ FAILURE TO RESPQ~D WILL RES~ILT IN AN QFFICIAL TAX ASSESSMENT ~ASED~°ON THIS ITICE A. ~IThe above information and tax due is correct. 1. You may choose to 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 you may 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. C 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 decedent's representative. C. ^ The above information is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART ^3 below. PART If you indicate a different tax rate, please state your OFFICIAL 17SE ONLY ^ AAF relationship to decedent: PA DEPARTMENT OF REVENUE TAX RETURN - COMPUTATION OF TAX ON ABOVE ASSET(S) PAD LINE 1. DOD Valuation 1 1 2. Percent Taxable 2 X ~ 2 3. Amount Subject to Tax 3 3 4. Debts and Deductions 4 - 4 5. Amount Taxable 5 5 6. Tax Rate 6 X ~ 6 7. Tax Due 7 7 \~~ 8 PART DEBTS AND DEDUCTIONS CLAIMED ^3 DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under p nalties of perjury, I declare that the facts I have reported above are true, correct and o best of my knowledge and belief. 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