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Home My WebLink About05-06-11 (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 RE:V-1162 EX(11-96) NO. CC) 014431 SCHMITT DAVID 6 EAST GREENHOUSE RD DILLSBURG, PA 17019 -------- fold ACN ASSESSMENT CONTROL NUMBER ESTATE INFORMATION: SSN: 185-16-5437 FILE NUMBER: 211 1-0558 DECEDENT NAME: CALVER ELIZABETH DATE OF PAYMENT: 05/09/201 1 POSTMARK DATE: 05/05/201 1 COUNTY: CUMBERLAND DATE OF DEATH: 04/ 15/201 1 REMARKS: SEAL CHECK# 606861 AMOUNT 11129176 ~ $3.60 TOTAL AMOUNT PAID: $3.60 INITIALS: HMW RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES - _ _ A N D Po Box z8o6o1 ~`-_ ~L'i4XPAYER RESPONSE HARRISBURG PA 17128-0601 _ n REV-1543 EX AFP ~(08-08) F I L E N 0. 21 ` ~° ~'~j'~ v I ACN 11129176 DATE 04-29-2011 EST. OF ELIZABETH CALVER SSN 185-16-5437 DATE OF DEATH 04-15-2011 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SgUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. ~:_ ~ ._ r~, ~~, ` ,-, ,-, ~~>~~. ~ _' ~ f ;~.'' ~ ~ ~a DAVID SCHMITT 6 EAST GREENHOUSE ROAD DILLSBURG PA 17019 MEMBERS 1ST FCU 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, attacFi 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 C717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 11450-11 Date 12-14-2009 To ensure proper credit to the account, two Established copies of this notice must accompany $ 5 0 5. 3 2 Payment to the Register of Wills, Make check Account Balance payable to "Register of Wi11s, Agent". Percent Taxable X 16.667 Amount Subject to Tax $- $4.22 NOTE: If tax payments are made within three months of the decedent's date of death, Tax Rate X . 045 deduct a 5 percent discount on the tax due. Any Inheritance Tax due will become delinquent Potential Tax Due $ 3.79 nine months after the date of death. PART TAXPAYER RESPONSE ~~ A;~-~~ ~s R~~Do~~~L~ S~LT~,.~,N AN O.,F'FICIAL TAX ASS~SS~ENT A. J~ii The above information and tax due is correct. rK,J 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 0 N E Mulls 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 estate representative. C. ~ The above informs ion is incorr~ect and/or debts and deductions were paid. Complete PART 2~ and/or PART I~ I below. PART If indicating a different tax rate, please --state OFFICIAL ~, ~~}\ relationship to decedent: ~~~~ ~~~.,.. PA DEPARTMENT OF REVENUE TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD LINE I. Date Established 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 $ 6 7. Tax Rate 7 X 7 8. Tax Due g $ 8 PART DEBTS AND DEDUCTIONS CLAIMED 3^ DATE PAID PAYEE DESCRIPTION AMOl1NT Fern Under penalties of perjury, I declare that the facts I have reported above are t ue), correct and omplete t best of my kn w edge and belief . HOME C7~ 7 ) 3~c ~-~~ WORK C ~ ~ . /~ XPAY I E TELEPHONE NUMBER A ~~:t+L ~cnLer on Line 5 or iax Computation) S~ _ r N ~ ~ . i' ' ~~ C ~ J - i r ;/~/ v a7 Mai v- G1 ~ ,.. i ~ ~"' • ~ ~ ~ ~~ ' e'D C ~ r, ~. f'' - lJr ~ - _ti- - ~ R'7 et~r~~ . , ~ a ~~ v rt ` .~ .:~ :~ r:; ;:; 'f =: i': t.. +..... w ~~ ..."*.. ........ *+..~. *w. ........ ....,,, ~~~ ~.. W ~:..... ~H. «..'~" «+.... ~~. titer .,. '~ ~'~ ~_~ ~J . P~~ /."'`. ti ~ ` ~ -~ ~G ~' ~ ~. .. ,S\\' ~. , ^ '` ` L a 11 a. `» \ Iv ~S, JJ ,~ r\ ,~ \\ ~ \/ , ~, ~ ~~4 '~ q ~ ~~ ' ~~ 1 \ ~ ~ ~1,` s ~`" '~ FF~ Liav, P ` ~ ~ \~ ~ ~`r i rT ~~ `~; i ' 4 l 'f F I\ t..~ ~ ` ~ i Ky L, i 1 . t. - ~ - Y. ~ ~. .~. _ . ~ r ~ ~ '' ,Y jT' « ' , ' ~ i ~' ` ~~' Y s ~ '~ ~ ~ -~ ~~ r q - > I~ } l'. !' :f, aanaaoe ~ aia~es~ ~d~-l ~ ? , ~ ~, °p~ 5 v, 3