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HomeMy WebLinkAbout07-11-11 (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 REV-1162 EX~11-96) NO. CD 014690 TERRY R WILSON 607 COPPER CIRCLE CARLISLE, PA 17015 -------- fold ESTATE INFORMATION: SSN: 246-28-1785 FILE NUMBER: 211 1-0763 DECEDENT NAME: LONG JANE DATE OF PAYMENT: 07/ 1 1 /201 1 POSTMARK DATE: 07/ 1 1 /201 1 COUNTY: CUMBERLAND DATE OF DEATH: 04/26/201 1 REMARKS: ACN ASSESSMENT AMOUNT CONTROL NUMBER 1 1 136181 ~ 515.46 TOTAL AMOUNT PAID: 515.46 CHECK# 2551 INITIALS: MAW SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS PENNSYLVANIA INHERITANCE: TAX INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES _ A N D Po Box z8o6o1 ; r,.~ .=1('~ TAXPAYER RESPONSE HARRISBURG PA 17128-0601 ,,, Y' ~ ~t/ REV 15 EX'AFP`f0~-Q871 ~;%~__1w~J FILE N0. 21~II~a,~~ ACN 11136181 DATE 05-26-2011 aRPN~ERK CF q~ S CQU~T CIIM~~~~-,s~ ~~ ~~'f j~ PA TERRY R WILSON 607 COPPER CIRCLE CARLISLE PA 17015 EST. OF JANE LONG SSN 246-28-1785 DATE OF DEATH 04-2b-2011 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT © SAVINGS CHECKING TRUST CERTIF. MEMBERS 1ST FCU 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 T+ax laws of the Commonwealth of Pennsylvania. Please call C717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 317066-00 Date 10-30-2007 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance 30 payment to the Register of Wills. Make check b87 $ . payable to "Register of Wills, Agent". Percent Taxable X 50.000 Amount Subject to NOTE: If tax payments are made within three Tax $ 343 b5 . months of the decedent's date of death, Tax Rate )( .045 deduct a fi percent discount on the tax due. Potential Tax Due Any Inheritance Tax due will become delinquent $ 15.46 nine montFJS after the date of death. PART TAXPAYER RESPONSE A. n The above information and tax due is correct. ~I 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. 0 N E 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 relationship to decedent: TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Date Established 1 2. Account Balance 2 $ ~~ 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 $ 5. Debts and Deductions 5 - 6. Amount Taxable 6 $ 7. Tax Rate 7 X \ 8. Tax Due 8 $ ~ ~ ~~ ~ PART DEBTS AND DEDUCTIONS CLAIMED 3^ DATE P AID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I have reported above ~~re true, correct and complete to the best of my knowledge and belief. H 0 M E C7~ 7 ) ~~ / ~~titi ~~~,r~ ~~~ ~~ WORK C ) ~AXPA ER SIGNATURE TELEPHONE NUMBER DATE TOTAL (Enter on Line 5 of Tax Computation) S