The URL can be used to link to this page

Home My WebLink About06-13-11 (2)REV-1162 EX(11-96) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: MARPOE BRYAN K 1416 RITNER HIGHWAY SHIPPENSBURG, PA 17257 fold PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ESTATE INFORMATION: ssN: iso-o~-9730 FILE NUMBER: 211 1-0670 DECEDENT NAME: BLACK THELMA A DATE OF PAYMENT: 06/ 1 3/201 1 POSTMARK DATE: 06/10/2011 COUNTY: CUMBERLAND DATE OF DEATH: 05/12/2011 ACN ASSESSMENT CONTROL NUMBER AMOUNT 11136930 ~ $713.24 TOTAL AMOUNT PAID: REMARKS: CHECK# 935 SEAL INITIALS: CJ RECEIVED BY: 5713.24 GLENDA EARNER STRASBAUGH REGISTER OF WILLS NO. CD 014564 REGISTER OF WILLS PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES AND FILE N0. 21 '-~~~ ~~(~ PD Box 28oco1 TAXPAYER RESPONSE ACN 11136930 HARRISBURG PA 17128-0601 DATE 05-30-2011 REV-1543 EX AFP (OB-08) TYPE OF ACCOUNT EST. OF THELMA A BLACK ^ SAVINGS SSN 180-01-9730 ^ CHECKING DATE OF DEATH 05-12-2011 ^ TRUST COUNTY CUMBERLAND ~ CERTIF. REMIT PAYMENT AND FORMS T0: PHYLLIS L MARPOE REGISTER OF WILLS 1416 RITNER HWY 1 COURTHOUSE SQUARE SHIPPENSBURG PA 17257 CARLISLE PA 17013 ORRSTOWN BANK 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 Comwonwealth of Pennsylvania. Please call C717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 30051195 Date 02-21 - 1995 To ensure proper credit to the account, two Established copies of this notice must accompany payment to the Register of Wills. Make check Account Balance $` 10 r 010 • 36 payable to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax payments are made within three Amount Subject to Tax $` 5 ~ 0 05 • 18 months of the decedent's date of death, X , 15 deduct a 5 percent discount on the tax due. Tax Rate Any Inheritance Tax due will become delinquent Potential Tax Due ~` 750 • 78 nine months after the date of death. PART TAXPAYER RESPONSE FAILURE 1`o RESPOND WILL RESULT IN Abl OFFICIAL TAX 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 a discount or avoid interest, or check box "A" and return this notice to the Register of CHECK Wills and an official assessment will be issued by the PA Department of Revenue. C 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 D 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 ~ and/or PART 3^ below. PART If indicating a different tax rate, please state OFFICiAL~t1SE Q~J..Y ^ AAF°"° relationship to decedent: PA DEPARTMENT OF REVENUE TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS \PAD LINE 1. Dete Established 1 1 2. Account Balance 2 $ Z 3. Percent Taxable 3 X 3 4. Amount Subject to Tax 4 $ 4 5. Debts and Deductions 5 S 6. Amount Taxable 6 $ 6 7. Tax Rate 7 X 7 8. Tax Due 8 '~ 8° \ PART DEBTS AND DEDUCTIONS CLAIMED 0 neTF PAID PAYEE DESCRIPTION AMOUNT PAID IUTAL ltnier vn L111C ~ „~r.. ~o -~~••- Under penalties of perjury, I declare that the facts I have reported above are fft rue, correct and co_mpQlete to the,bepst of my knowledge and belief. HOME C ~ ~~ ~ 7 ~~-~ •~~ Q ~Tl- ~i ~! '~f ,n79-P.~ WORK C ) 5 I ~., ter.-.(.T((o~ TELEPHONE NUMBER DATE t A i t 1 i ,~ t f f i r S~ 0 a x ,~. ~ ,~~ 3.~ds,~,a ~; ;: ~. r~. .. ~k~r . ~ i~;.t ~.: ~i'`; ,, r~,. k?:: `~`~ w; v ~' ~3 ~. `~i +Y 3:; ~"; 1.; 4s:} 1 f 1 1 " I ~„~ ~~ fl ~ ~' 3 t ~ _, ' ~ i ~ ~ ~ ~- w ~ : 4. r - ,9 K _ T Z Ll- ."'- ~ !g Y. .~ ~ ~ M }-1 ~ ° ~ ~ ~ t~.- 0 ~ ~ ~/ ~ 7~G ~ ' . ` W V~`` .-. V ,~ !r! (;'~} ~-t ~_ t~~ r3 ~~ t •r3 ~,