HomeMy WebLinkAbout04-01-11COMMONWEALTH OF PENNSVIVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0801
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NGO OANH B
108 WESLEY DRIVE
MECHANICSBURG, PA 17055
,oa
ESTATE INFORMATION: ssN: sas-5s-saga
FILE NUMBER: 211 1-0423
DECEDENT NAME: LANPHUONG QUAN
DATE OF PAYMENT: 04/01 /201 1
POSTMARK DATE: 03/31 /201 1
COUNTY: CUMBERLAND
DATE OF DEATH: 03/09/201 1
REV•1162 EX111-961
N0. CD 014232
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
11118632 ~ 582.73
TOTAL AMOUNT PAID:
REMARKS: OANH NGO
CHECK#1537
SEAL
INITIALS: WZ
RECEIVED BY
582.73
GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE ~[~~
.~uE ~ AND FILE N0.21 -. ~15~~, ~'1~
BUREAU OF INDIVIDWL TA%ES ,
Po eDx z6osal .. .,,. TAXPAYER RESPONSE ACN 11118632
HARRISBURG PA 17128-0601 , r» } !. ; ' ;r'~ (~ ` C
DATE 03-22-2011
REV-1541 E1I ~FP (IR-iR)
! Pry !2= 3 ~
ORPHAN'S 4URT
CUMBERLAdVD ~0 , PA
OANH B NGO
108 WESLEY DRIVE
MECHANICSBURG PA 17055
EST. OF LANPHUONG QUAN
SSN 586-54-6474
DATE OF DEATH 03-09-2011
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 tho
potential tax dua. Records indicate that at the death of the above-named decedent, you ware a ioint owner/beneficiary of this account.
If you feel the information is incorrect, Dlsase obtain written correction from the financial institution, attach a copy to this form
and return it to the above atldress. This account is taxable in accordane• with the Inheritance Tax laws of the Coaaorn+eslth of
Pennsylvania. Pleas• call C717) 787-6327 with questions.
COMPLETE PART I BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 26770 1-1 1 Date 07-09-2005 To ensure proper credit to the account, two
Established copies of this notice oust seeomparry
payaent to the Raaister of Wills. Make check
Account Balance ~` 6 7 7. O 4
3i payable to "Register of Wills, Agent".
Percent Taxable X 50.000
NDTEr If tax pavunts an made within thrw
Amount Subject t0 TeX ~ 838.52
li aonths of the decedent's data of death.
Tax Rate X .045 deduct a 5 percent discount on the tax dua.
Arty Inheritance Tax due will becoae delinquent
Potential Tax Due #` 82.73 nine aonths after the date of death.
PART TAXPAYER RESPONSE
1^
A. ~ The above information and tax due is correct.
Resit 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 Resister of
C ONE ~ Wills and an official assessment will b• issuetl by the PA Department of Revenue.
BLOCK 6. ~ Tha above asset has been or will be reportetl and tax paid with the Pennsylvania Inheritance Tax return
ONLY to be filed by the esteto reprasantativa.
C. ~ Tha above informs ion 1s ineorreet and/or debts and deductions were paid.
Coaplets PART 2~ and/or PART ~ below.
pART If indicating a different tax rata, please state
O relationship to decedent:
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
LINE 1. Data Established
2. Account Balance
3. Percent Taxable
4. Amount Subject to Tax
5. Debts and Deductions
6. Amount Taxable
7. Tax Rats
8. Tax Due
PART
1
2 ~
3 X
4
5
6 ~
T X
8 ~
DEBTS AND DEDUCTIONS CLAIMED
TOTAL CEnter on Lino 5 of Tax Computation) i
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
complete to the bast of my knowletlgo and belief. HOME C ) `v~.J
WORK C )
TAXPAYER SIGNATURE TELEPHONE NUMBER DATE
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
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