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HomeMy WebLinkAbout06-21-11COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX111-961 NO. CD 014614 HERMAN MARITA 1 PENNS WAY ROAD MECHANICSBURG, PA 17050 fold ESTATE INFORMATION: SSN: oo0-00-0000 FILE NUMBER: 211 1-0701 DECEDENT NAME: PANZA ELVIRA A DATE OF PAYMENT: 06/21 /201 1 POSTMARK DATE: 06/20/201 1 COUNTY: CUMBERLAND DATE OF DEATH: 06/07/201 1 REMARKS: ACN ASSESSMENT AMOUNT CONTROL NUMBER 1 1 141393 ~ 5.50 11141392 ~ 546.01 TOTAL AMOUNT PAID: 546.51 CHECK# 686 INITIALS: CJ SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES PD BDX 266601 pennS HARRISBURG PA 17128-0601 DEPARTMENTOrrq REV-1543 EX A PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE FILE N0. 21 -~1'~~~ ! '.t .. ~{('~ AND r',;,. za ~{ TQ4XPAYER RESPONSE ACN 11141393 "'; ~,~~ ;+~,.M~~ DATE 06-16-2011 `~i~' `~~~ ~ ( ~~ ~ ~c ~-~ EST. OF ELVIRA A PANZA SSN 202-20-7488 C~ERK Q~ DATE OF DEATH 06-07-2011 C`~d~Ip?H i~Iq~S vO/U~RT x COUNTY CUMBERLAND ~~~f>~~~~A~'3~ ~i./., ~N• REMIT PAYMENT AND FORMS TD: MARITA P HERMAN REGISTER OF WILLS 1 PENNS WAY ROAD 1 COURTHOUSE SQUARE MECHANICSBURG PA 17050 CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS © CHECKING TRUST CERTIF. MEMBERS 1ST FCU provided the department with the information below, which was used in calculating the inheritance tax due. Records indicate that at the death of the above-named decedent, you were a joint owner/beneficiary of this account. If you are the Spouse of the deceased and any amount other than zero is reflected below on the Potential Tax Due line, note no tax may be due, but you must notify the department of your relationship to the deceased by checking Box C in PART 1 below and writing "spouse" in PART 2. If you believe 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. Please call 717-787-8327 with questions. COMPLETE PART 1 BELDW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 226276-1 1 Date 01-27-2003 To ensure proper credit to the account, two Established copies of this notice must accompany $ 1 , 964.14 payment to the Register of Wills. Make check Account Balance payable to "Register of Wills, Agent". Percent Taxable X 50.000 Amount Subject to Tax $ 9$2.07 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 $ 44.19 nine months after the date of death. PART TAXPAYER RESPONSE 0 ~: FAILUR~TO RESPOND ~ SIN \~ ICIA 7~~ SSESSMENT 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 ar avoid interest, or return this notice to the Register of Wills and C 0 N E ~ 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 D N L Y 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: \ PA DEPARTMENT OF REVENUE TAX RETURN - CALCULATION OF TAX N JO NT/TRUST ACCOUNTS pAD LINE i. Date Established 1 ®~ ~~~~ ~~~~ i ------ -----__-__ 2. Account Balance 2 $ ,~ ~ (® `~. ~°~ Z 3. Percent Taxable 3 X Ste, od:~ 3 4. Amount Subject to Tax 4 $ ~Q~ ~'/ 4 5. Debts and Deductions 5_ - 4~©. 8 ~~~~~~ 5 6. Amount Taxable 6 $ ~ ~'. ~~ 6 7. Tax Rate 7 X _._~ O~/$' 7 8. Tax Due 8 $ ~~~- ~'O 8 PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID ~ - / -.fib! ! ~ ~'iQe IP Q.C.. L l2 6 X41- ~ ® . ~ u is,~ center on une s or i ax Computation) S y ~®, ~~ Under penalties of perjury, I declare that the facts I reported above are true, correct and complete to the best of m kno ledge and belief . HOME C 7 ~ 7 ) ~ I _S' ~ ~ ~ t' inn ~ ~ /~ i ~ - - - _ -~ ~~ PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES F I L E NO . 21 - ~ I -~ PO box 280601 Pen ~f r~i AND HARRISBURG PA 17128-0601 F' ~.yFT j ~j~ ~~ ACN 11141393 DEPARTM~ ~~,~•N(j~~ ' ` AXPAYER RESPONSE REV-1543 ~~SL3},~,j) ,~~~~,~1f DATE 06-16-2011 ~~~' t '~~~ ~ ~ ~°~~~' k'' ~~' EST. OF ELVIRA A PANZA SSN 202-20-7488 C~ER~ QF DATE OF DEATH 06-07-2011 O~Pf-~AN~S (;OURT COUNTY CUMBERLAND ~' JNfl~~~,..r"~u'`,1) ~~, ~ REMIT PAYMENT AND FORMS T0: MARITA P HERMAN REGISTER OF WILLS 1 PENNS WAY ROAD 1 COURTHOUSE SQUARE MECHANICSBURG PA 17050 CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS ® CHECKING TRUST CERTIF. MEMBERS 1ST FCU provided the department with the information below, which was used in calculating the inheritance tax due. Records indicate that at the death of the above named decedent, you were a joint owner/beneficiary of this account. If y0U are the SpOUSe Of the deceased and any amount other than zero is reflected below on the Potential Tax Due line, note no tax may be due, but you must notify the department of your relationship to the deceased by checking Box C in PART I below and writing "spouse" in PART 2. If you believe 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. Please call 717-787-8327 with Questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 226276-11 Date 01-27-2003 Established To ensure proper credit to the account, two copies of this notice must accompany Account Balance $ 1 , 964.14 payment to the Register of Wills. Make check payable to "Register of Wills, Agent". Percent Taxable X 50.000 Amount Subject to Tax ~` 982.07 NOTE: If tax payments are made within three months of the decedent's date of death, Tax Rate )( .045 deduct a 5 percent discount on the tax due. Potential Tax Due $ 44.19 Anv inheritance tax due will become delinquent nine months after the date of death. PART TAXPAYER RESPONSE 1^ AILUR6\~~0 RESPONI~~~ \ ~ \ ,\:`~IN \, OFFICIAL TA ~SSESSMEF~ A. ~ The above information and tax due is correct. Remit payment to the Register of Wills with two co pies of this notice to obtain C H E C K 0 N E a discount or avoid interest, or return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. [ B L O C K ~ g, ~ The above asset has been or will be reported and tax paid with the Pennsylvania inheritance tax return 0 N L Y filed by the estate representative. C. The above infarma ion is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART ~ below. PART If indicating a different tax rate, Please state relationship to decedent: TAX RETURN - CALCULATION LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due OF TAX ON JOINT/TRUST ACCOUNTS 1 CJ1~ a~!- ~C7~~ 2 $ 4~q~L~ 14 3 X `~ O o UT O G 4_. $ ~ ~~ I ~~,~ 5 - l ~ q ~ ~ . t~ 6 '~ ~~_ ~ Q z X .OyS PAD 1 2 3 4 5 6 ...~ ~ 7 8 OFFICIAL°USE ONLY ~ AAF PA DEPARTMENT OF REVENUE PART DEBTS AND DEDUCTIONS CLAIMED ^S DATE PAID PAYEE DESCRIPTION AMOUNT PAID - 'G - . O l /1) C~ , ..~ P L L ~N L NU S~rN - nl E 1 LL ~ U , iui.1~ \CnLer vn Line D or IaX l:O mpULaLlOn) $ / /~ X K Under penalties of perjury, I declare that the facts I reported above are true, correct(,apnd complete to the best-~oDf my knowledge and belief. HOME C ~ 7 ) 95 O p 0.. 1 ~ ~ n -~vv~c_Y nn W 0 R K C -7 ( 7 ) `] 7 O -- ~, S c' ~ ,)~ TAXPAYER SIGNATURE TELEPHONE NUMBER DAT ^°'9 ~~' f~{'; q-•9 ~, a~, r .:. 3..t. ,~d ~f f i~ sue,, ~5 ,~' ;;.~ t"~ a i v-. .~~.A M~ ~y'' ¢% • l.. F~ =~~i v~% ?~,l n n O O n a ~ a 2 Q os a~~ ~9 ~ U ~ N C ~ L ~ a ~ M o r 3 ~'° 9 `~ 1 ~o ~a~~~ ~., r {~ J i Ili, ','. {jj``''~(( . 4 - ~ V ~4J Le ~~~ {yy 3'} f•!:g (rS .=..f 3 ~~! s~:' ~ .. .i..~