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Home My WebLink About06-02-11COMMONWEALTH 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 NO. CD 014535 ANDREOLI SAMUEL J 20 APPALOOSA WAY CARLISLE, PA 17015 -------- fold ACN ASSESSMENT ,AMOUNT CONTROL NUMBER ---------- -------- ESTATE INFORMATION: ssrv: ~ 84-~ 2-2668 FILE NUMBER: 211 1-0599 DECEDENT NAME: ANDREOLI ROSEALIE DATE OF PAYMENT: 06/02/201 1 POSTMARK DATE: 06/01 /201 1 COUNTY: CUMBERLAND DATE OF DEATH: 04/ 20/ 201 1 REMARKS: SEAL CHECK# 2772 11130288 ~ ;44.91 TOTAL AMOUNT PAID: REV-1162 EX(11-96) ~~44.91 INITIALS: DB RECEIVED BY: GLENDA EARNER STR,ASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUA~~~Ebi-yf}~~ '~'r PO BOX 280601 ' ' ' "'~`" "~~ HARRISBURG PA 17128-~.q~j~~ ; ~,~,~ ;Y . `-.`. ~ REV-1543 EX AFP COB-08) PENNSYL~JANIA INHERITANCE TAX INFORMATION NOTICE AND TAXPAYER RESPONSE - ~~ `. FILE N0. 21 - i I ACN 11130288 DATE 05-04-2011 '~~~ ~ ~Ufd -2 ~~~ ! 1 i CLERK C~ {ORPHAN'S c~Q~.~RT ~l1l~P~-Pi_.~.Pc~ ~~., PA. SAMUEL J ANDREOLI 20 APPALOOSA WAY CARLISLE PA 17015 EST. OF ROSALIE ANDREOLI SSN 184-12-2668 DATE OF DEATH 04-20-2011 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 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. 127006-1 1 Date 04-30-2007 To ensure proper credit to the account, two Established copies of this notice mus1t accompany 11 ~ 977.15 payment to the Register o~F Wills. Make check Account Balance ~` payable to "Register of Wills, Agent". Percent Taxable X 8.333 NOTE: If tax payments are made within three Amount Subject to Tax $ 998.06 months of the decedent's ciate of death, Tax Rate J( . 045 deduct a 5 percent discount on the tax due. Any Inheritance Tax due w'.ill become delinquent Potential Tax Due $` 44.91 nine months after the data of death. PART TAXPAYER RESPONSE 0 -~ FAit 0\~~`ESR1I7 WILL~tESULT I ' ~ AN UFFiC~i4L T.yAX ASSESSMENT 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 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 estate representative. C. ~ The above informs ion is incorr~ect and/or debts and deductions were paid. Complete PART 2~ and/or PART u below. PART If indicating a different tax rate, please state OF~~~TC.~/~L ,USE QNLY.~~~~~~ AAA 2 relationship to decedent: \\ PA DEPARTMENT OF REVENUE TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD ' Data .rs,ita::.il~h6.-'i i 1 2. Account Balance 2 $ 2 3. Percent Taxable 3 X 3 4. Amount Subject to Tax 4 $ 4 5. Debts and Deductions 5 - ~ 6. Amount Taxable 6 $ 6 7. Tax Rate 7 X 7 8. Tax Due g $ 8 PART DEBTS AND DEDUCTIONS CLAIMED 0 DATE PAID PAYEE DESCRIPTION AMOUNT PArn U der penalties of t jury, I declare that the facts I have reported above are true, correct rand c mplete to e~b df my, knowledge and belief . HOME C ~~ 7 ) c~[ ~~7 ~ `,~vQ f TA AYER SI NA URE TELEPHONE NUMBER DA E ~, IUINL ~tnter on pine 5 of Iax Computation) $ RE~~~c i ,~ .- ~~~~.~ _ ~;'~ _~ ~J L~ 1 d JU~1-2 CLERK OF ORPHAIV'~ ~C~[~AT CtII~E~=~~~..~ii~~~ ~ ~r;`~ , pq - `_" ~.:~ '..~ ~i~~' rwT~u YI ~. v ' Y ~ F ~^ ~ _ , ~' +:3 ~~ T1 ~ ~',' ~~. V~ ._r. ~ -4- '~ ~ •--~ ~' ~ ~,,~~ .~.. ,~ .`~, ~~/, • `•~~ --~/i__ '~ ~` ~ 3~ 3f +~" v ~ d~ ~ .s, a~ 3 ,~ 4 + '~ ',t ~ it !:,'s a ~~ .~ ~. `t ~;: s ~~~ ~ s~d~~~i~~i; sn