HomeMy WebLinkAbout06-01-11COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1 7 1 28-0601
RECEIVED FROM:
HUFFNAGLE DEBDRA H
1358 KILEE PAL 17015
CARLIS ,
______-- fold
ESTATE INFORMATION:
SSN: 162-22-1659
FILE NUMBER: 211 1-0635
DECEDENT NAME: HUMPHREYS B A
DATE OF PAYMENT: 06/01 /2011
POSTMARK DATE: 05/23/2011
CUMBERLAND
COUNTY:
DATE OF DEATH: 07 / 01 / 2010
TOTAL AMOUNT PAID:
REMARKS:
CHECK# 157
SEAL
REV-1162 EX(11-96)
PENNSYLVANIA
INHERITANCE AND E PIPT E TAX
OFFICIAL REC
N0. CD 014530
$77.31
GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
INITIALS: HMW
RECEIVED BY:
REGISTER OF WILLS
ACN AMOUNT
ASSESSMENT
CONTROL
NUMBER ________
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
AND
BUREAU OF INDIVIDUAL TAXES ~ ~~~~ ~~TAXPAYER RESPONSE
Po Box z8o6o1 ._ , , r ~~~~ ~ ~,
HARRISBURG PA 17128-0601 ,-~, f ,..,,F, + ;,, ,i
REV-~~' ~ ,~~ ~8~ 0~ ~ ~ 1.~••'J
FILE N0. 21 ' ~ (~~~=~
ACN 111 3104
DATE 05-16-2011
TYPE OF ACCOUNT
~~.~ ~r), ~~V ~ SAVINGS
~Y= ~ ~~~ - tC[ V EST. OF B A HUMPHREYS ® CHECKING
SSN 162-22-1659
TRUST
~~~ bra Humphrc, ~ H~flnagl~ ~K O~ DATE OF DEATH 0 7 - O 1- 2 010 ~ CERT I F .
1358 Kiner Blvd. ~["t~lf'1~I~~ ~~~T COUNTY CUMBERLAND
Carlisle„ PA 17015 R~~I ~.~~ ~1~ pq REMIT PAYMENT AND F(1RMS T0:
a._~.~:
H HUFFNAGLE REGISTER OF WILLS
DEBRA 1 COURTHOUSE SQUARE
CARLISLE PA 1 ~~013
K provided the Departmeabove tnamed decedentl you were a jo nt owner/beneficiary of this account.
METRO BAN
potential tax due. Records indicate that at the death of the
el the information is incorrect, Please obtain wrletin accordance with the InheritancenTaxtlawsnofathecCommonwealthtofs orm
If you fe
and return it to the above address. This account is taxa
Pennsylvania. Please call C717) 787-8327 with questions.
E PART i BELOW * SEE REVERSE SIDE FOR FiLiNG AND PAYMENT iNSTRUCTiONS o
COMPLET
Date 05-30'2006 To ensure proper credit to the account, tw
Account No. 537304982 copies of this notice must accompany
Established payment i:o the Register of Wills. Make check
3,436.00 payable 1;0 "Register of Wills, Agent".
Account Balance $ 50.0 0 0
Percent Taxable X NOTE: I~F tax payments are made within three
1 , 718.00 months of the decedent's date of death,
Amount Subject to Tax • 15 deduct a 5 percent discount on the tax due.
Tax Rate X Any Inheritance Tax due will become delinquent
257 , 70 nine months after the date of death.
Potential Tax Due $
TAXPAYER RESPONSE
,.
~ AX
~~~~~
A.
CHECK
ONE
BLOCK B•
ONLY
C.
The above information and tax due is correct.
Remit pavmeo~ avoideinterestr or check box h'A'w and preturn this notice to theaRegister of
a discount
Wills and an official assessment will be issued by the PA Department of evenue.
The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
to be filed by the estate representative.
The above informs ion is incorrect and/or debts and deductions mere paid.
Complete PART 2~ and/or PART ~ below.
If indicating a different to ate 1 e tate
PART relationship to decedent:
OMPUTATION OF TAX ON DINT/TRUST ACCOUNTS
TAX RE TURN - C
LINE 1. Date Established
2. Account Balance 2
X
3 Percent Taxable 3
.
4.
Amount Subject to Tax 4 $ ~~ ~ (~.~
-
5. Debts and Deductions 5 $ 'OO
6 Amount Taxable 6
. ~ X
7. Tax Rate
~ . _ . T .. w
PART
DATE
DESCRIPTION
AMOUNT PAID
TOTAL CEnter on Line 5 of Tax Computation)
s
Under penalt'es of perjury, I declare that theffacts I have
complete t he best f my knowledge and belie
~\ n.._ ~ _ ~_^^~w reported( love ~ e true,~
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WORK ~ ~nCD correct and
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DATE
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