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HomeMy WebLinkAbout06-15-11 (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 NO. CC- 1014578 EDWARDS SHEILA E 415 E GREEN STREET SHIREMANSTOWN, PA 17011 ---- fold ACN ASSESSMENT AN10UNT CONTROL NUMBER ---------- -------- ESTATE INFORMATION: SsN: ~ 86-28-5533 FILE NUMBER: 211 1-0679 DECEDENT NAME: ODONNELL WILLIAM A DATE OF PAYMENT: 06/ 1 5/201 1 POSTMARK DATE: 06/ 14/201 1 COUNTY: CUMBERLAND DATE OF DEATH: 09/ 22/ 201 0 REMARKS: SEAL CHECK# 6466 10158587 ~ $68.19 TOTAL AMOUNT PAID: I~EV-1162 EX111-96) $68.19 INITIALS: DB RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS PENNSYLVANIA INHERITANCE TAX INFORMATION NOTII:E BUREAU OF INDIVIDUAL TAXES , A N D Po Box 280601 ' t~'~~y'~~~ O~AXPAYER RESPONSE HARRISBURG PA 17128-0601 ~~, ~, ~ ,t,rl} { C ~,, ~ ' REV-1543 ~X ~AFd" (SOS`-OB> ~~~- CLERK OF ORPHAN'S COURT C~1h~~R~P~.~"~~ ~`~~ . PA SHEILA EDWARDS 415 E GREEN ST SHIREMANSTOWN PA 17011-6722 F I L E N O. 21 - ~ ~- ~„~~ ~~ ~~ ACN 10158587 DATE 10-14-2010 EST. OF WILLIAM A ODONNELL. SSN 186-28-5533 DATE OF DEATH 09-22-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT © SAVINGS CHECKING TRUST CERTIF. PS ECU provided the Department with the information below, which has been used i.n 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 Psnnsyl~ania. Please call X717) 787-8327 with questians. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 0186285533-S4 Date 10-21-1982 To ensure proper credit to the account, two Established copies of this notice must accompany 9, 091 .82 payment to the Register of Wills. Make check Account Balance Davable to Register of Wills, Agent". Percent Taxable X 16.667 NOTE: If tax payments are made within three Amount Subject to Tax ~` 1 , 515.33 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 $ 68.19 nine months after the date of death. PART TAXPAYER RESPONSE 1^ FAIL~i#tE"' ~ RESOD WILT. RESULT IN AN OFFICIAL TAX ASSESSMENT A. a 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 O N L Y to a filed by the estate representative. C. The above informs ion is incorrect and/or debts and deductions were paid. omplete PART ~2 and/or PART LJ below. PART If indicating a different tax rate, please state OFFICIAL l1SE DN-L~` '~ AAF relationship to decedent: PA DEPARTMENT OF REVENUE TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD LINE 1. Date Established 1 1 2. Account Balance 2 +fi 2 3. Percent Taxable 3 X 3 4. Amount Subject to Tax 4 $ ~ 5. Debts and Deductions 5 - 5 6. Amount Taxable 6 $ 6 7. Tax Rate 7 X ~ 8. Tax Due g $ $ PART DEBTS AND DEDUCTIONS CLAIMED 0 DATE PAID PAYEE DESCRIPTION AMOUNT PArn Under nalties of compl tb- the bes R SIGNATURE ury, I declare that the facts I have reported above are true, correct and my knowledge and belief. HOME C~T~ ) ~~~~ , WORK ( ) TELEPHONE NUMBER ~I D T / ., I,+~ \CII lC!- on pine 5 or i ax computation) $