HomeMy WebLinkAbout04-21-11COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1 7 1 2 8-0 601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1162 EX~11-96)
NO. CD 014350
FOREMAN BRUCE D
1 12 MARKET STREET F16
HARRISBURG, PA 17101
fold
ESTATE INFORMATION: ssrv: 565-26-6226
FILE NUMBER: 2110-1279
DECEDENT NAME: AMNOTT THELMA I
DATE OF PAYMENT: 04/21 /201 1
POSTMARK DATE: 04/20/201 1
couNTY: CUMBERLAND
DATE OF DEATH: 12/26/2010
REMARKS:
CHECK# 313
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
TOTAL AMOUNT PAID:
INITIALS: CJ
5977.10
SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
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PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
9UREAU OF IMDIYI~UAL TA7CE5 A N D
PO enx 2tlo6ol TAXPAYER RESPONSE
l1(~RISBURF Px ;T771Ztl-n6o1
CJ G.-, ,..,vr
_ _ . 4~ xer.lsee er ~~r cos-au
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LA._ ' 1_ '~-.~'
LY_ TER~$A H ~STICE
75$~ LAKESI~ AVE
HARRIS6URG PA 17112-4211
Account No. 5140133959
FILE N0, 21 10-1279
ACN ],1117203
GATE 03-14-2011
EST. .OF THELMA AMNOTT
SSN 565-26-6226
DATE 'OF DEATH 1Z-26-2010
COUNTY CUMBERLAND
REMIT PAYMENT AND FDRf1S T0:
RE~ISTER,OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
13,027.98
' Ir; Te ensure preoer credit to the account, trp
~" copies of this notice must accampanr
~ ~pavment to the Register of Wills- !lake check
~ ~payablx to "Ro
9 9istxr pf uil l,5, g9ent".
$ 6,513.99 ~~ d
X . 15 I ' ~
i
$ 977.].0 I
TAXPAYER RE5PON5E
^ The abavo information and tax duo is carra c{-
Remit oeyment to the Register of Wi113 with
a discpunl' or avoid interest, or check box '
Wilts and en effieial assessment will be is.
The aba~a as sat has boon ar wit] bn ra po rtad ant
tm be filed by the esta l'c rl•p rc~en la live.
The abo.c informs ion is inearrc et and/or debts
Conplete PART ~ and/or PART ~ below.
PART If SndSeaLing a different tax raft-, Dlmase wtaty
^Z relation3hip to decedent:
TAX RETURN - coMPUTATIoN OF TAX vN JvINT/TRUST AccDU
----ter- ~ ~-~------ .. .. _ _ I
2. Account Balance 2 $ ~
3_ Pcrecntc Taxablm 3 x
5. Amount SuD7ect to Tax 4 +S
NOTES If tax payments are matle within tnrex
months of the docedant's data of doath,
deduct a 5 percent discount on the tax duo.
Arty Inheritance Tax duo will bocoao dalinauont
nine gpntns after the (late of tleath.
o~capios pf this notice to obtain
dnd return this notice to thx Rxyis#ar pf
tlCby the PA Departacnt of Rc.anuc.
5. Debts and Deducticns 5 ~{~' ~~ rte'
6, Amount Taxable 6 $ ~ ;;;;ih~;'~Si
Date 09-17-2008
Established
TYPE OF ACCOUNT
SAVINGS
® CHECKING
TRUST
CERTIF.
PNC BANK NA provided !ha Dxpartmant with the informationmelow, which has Deen usetl Sn cale~letlne the
patxnti al tax dux. kecertls lntllcdte that ![ the tlea[M1 of the ebor!-named de cc dcn't, ya 4 woro a jpint pwnor/banaf i~iary of this apapunt.
If you fxxl the information is incprrect, please oDtaln wrltten eerrectfen fre^ !ha ~ 'j~naial institution, attach a copy to this form
end return if to the above address_ This account is taxable in accordance wjLn the Ilerltance Tax Iaws of Ue Cemmenweelth of
Pennsylranie_ Plcasp_call C7171 T8T-Bi27 with quostlnns. _ _ __ __ _~ 1
' .. L.'.-_ ___ .
COMPLETE PART 1 BELOW fs SEE REVERSE SIDE FDR FILfN6 AND PAYMENT INSTRUCTIONS
Account Balance
Percent Taxable
AmGUC1t SubSect to Tax
Tax Rate
Potential Tax Due
PART
~,
DEBTS AND DEDUCTIDNSi' CLAIMED
U
DATE PAID PAYEE DESC I
i
RL~~TION AMOUNT PAID
II I II
I~ I:i
IC I II ~
I I it I
TDTAL. CEnter on Line 5 ol ~ax Comvutatian) 8
Under Denalties of perjury, I declare that the facts l Rave I
eempiete to the best of my knowledge and belief.
~
~ Dort,ed above are true, correct and
;ME.I C
W ~RK~I I ( l
b.
TAXPAYER SIGNATURE I I~ TELE~HONE NUMBER DATE
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