HomeMy WebLinkAbout06-15-11 (3)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. CD 014579
EDWARDS SHEILA E
415 E GREEN STREET
SHIREMANSTOWN, PA 17011
-------- fold
ESTATE INFORMATION: SSN: ~ 86-28-5533
FILE NUMBER: 21 1 1-0679
DECEDENT NAME: ODONNELL WILLIAM A
DATE OF PAYMENT: 06/ 15/201 1
POSTMARK DATE: 06/14/201 1
COUNTY: CUMBERLAND
DATE OF DEATH: 09/22/2010
REMARKS:
ACN
ASSESSMENT A~JIOUNT
CONTROL
NUMBER
10158589 ~ 58.08
TOTAL AMOUNT PAID:
58.08
CHECK# 6468
INITIALS: DB
SEAL RECEIVED BY: GLENDA EARNER STR.ASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
PENNSYLVANIA INHERITANCE TAX
INFORMATION NOTICE
BUREAU OF INDIVIDUAL TAXES A N D
Po Box 2so6ol t" ~ TAXPAYER RESPONSE
HARRISBURG PA 17128-0601 i~t_ll~ _ ~~ ~~i/ .
F I L E N i0. 21 - ~ `-~~„~ ~~- C~
ACN 10158589
DATE 10-14-2010
'v~~i ~ ~~N i 5 ~'3~ ~~~ ~,~
CLERK Or
OR°HA1~'S ~QURT
~t~~~~r~~~,~c c~. ~a
SHEILA EDWARDS
415 E GREEN ST
SHIREMANSTOWN PA 17011-6722
EST. OF WILLIAM A ODONNELI_
SSN 18b-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.
PSECU 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 Commionwealth of
Pennsylvania_ Please call :717: 787 8327 :rites questions.
COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUt:TIONS
Account No. 0186285533-C51 Date 12-21 - 1982 To ensure proper credit t~o the account, two
Established copies of this notice must accompany
payment to the Register of Wills. Make check
Account Balance $ 1 ~ 077 • 11 payable to "Register of Wills, Agent".
Percent Taxable X 16.667
NOTE: If tax payments are made within three
Amount Subject to Tax $ 179.52 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 $ 8.08 nine months after the date of death.
PART TAXPAYER RESPONSE
~FAILU , '~~~~~ES~p W~~L RE~1LT IN Ali t?FFICTAL TAX ASSESSMENT
A. `/t The above information and tax due is correct.
~~II 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
Wills and an official assessment will be issued by the PA Department of Revenue,
ONE
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 incorrect and/or debts and deductions were paid.
Complete PART 2~ and/or PART 3~ below.
PART If indicating a different tax rate, please state OFFICIAL USE ONLY ~ AAF
relationship to decedent:
2 PA DEPARTMENT OF REVENUE
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS PAD
LINE 1. Date Established 1 1
2. Account Balance 2 $ 2
3. Percent Taxable 3 X 3
4. Amount Subject to Tax 4 $ CE
5. Debts and Deductions 5 - ~j
6. Amount Taxable 6 $ b
7. Tax Rate 7 X ~'
8. Tax Due 8 $ g
PART DEBTS AND DEDUCTIONS CLAIMED
3^
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
Under enalties of per' ry, I declare that the facts I have reported above are true, correct and
compl t to th est f y knowledge and belief . HOME C~ j~ ~~~ C~' -G~j 1V /
WORK ( )
TAXP~ER SIGNATU
R
DATE
TOTAL (Enter on Line 5 of Tax Computation) 5