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HomeMy WebLinkAbout07-18-11REV-1162 EX(11-96) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: FRIEND MARK R 506 OHIO AVE LEMOYNE, PA 17043 fold PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ESTATE INFORMATION: SSN: 214-20-8809 FILE NUMBER: 211 1-0091 DECEDENT NAME: FRIEND MARGARET C DATE OF PAYMENT: 07/18/2011 POSTMARK DATE: 07/ 10/201 1 couNTY: CUMBERLAND DATE OF DEATH: 01 / 1 1 / 201 1 ACN ASSESSMENT CONTROL NUMBER AMOUNT 11146160 ~ 592.73 TOTAL AMOUNT PAID: REMARKS: CHECK# 97 SEAL INITIALS: CJ RECEIVED BY: 592.73 GLENDA EARNER STRASBAUGH REGISTER OF WILLS NO. CD 014723 REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES c PO BOX 280601 penes ~.,{, `~ HARRISBURG PA 17128-0601 DEPARTMENT O~~Y~4 REV-1543 El( AFP (OS -11) c~.E~~ ~~ pRP~~)S ~dURTpA ay,,~~.~~.~(, .,t, , ARIANA L FRIEND NUT PA 17011 o it a A-k,~- G~~...~ EST. OF MARGARET C FRIEND SSN 214-20-8809 DATE OF DEATH 01-11-2011 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT © SAVINGS CHECKING TRUST CERTIF. WELLS F A RGO provided the department with the information below, which was used in calculating the inheritance tax due. deceaseddandtanyaamounteother thanezeroelsareflectedtbelowwonethe~Potentialb TaxlDueylineh)note~no tax mayo be due hbut you must he 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 ouestions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 3086016478003 Date 12-12-1994 7o ensure vroper credit to the account, two Established copies of this notice must accompany payment to the Register of Wills. Make check Account Balance $ 3,709.00 payable to "Resister of Wills, Agent". X 1 6 .6 6 7 NOTE: If tax payments are made within three Percent Taxable Amount Subject to Tax $ 618 • 18 months of the decedent's date of death, X • 1 5 deduct a 5 percent discount on the tax due. Tax Rate AnY inheritance tau due will become delinquent Potential Tax Due $ 92 • 73 nine months after the date of death. PART TAXPAYER RESPONSE FAILURE PTO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT I'yThe above information and tax due is correct. A of t i his notice to obtain , es LLLLLL Remit payment to the Register of Wills with two cop the Register of Wills and t a discount or avoid interest, or return this o notice artment PA De of Revenue. C H E C K an official assessment will be issued by the p C ONE will be reported and tax paid with the Pennsylvania inheritance tax return B L 0 C K B. ~ The above asset has been or 0 N L Y filed by the estate representative. ~ The above informs ion is incorrect and/or debts C and deductions were paid. , Complete PART ~2 and/or PART ~ below. (- w r 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 e Tom., rn)p OF TAX ON JOINT/TRUST ACCOUNTS 1 2 3 X 4 5 6 '~ 7 X s $ PAD urr1L1A~ ~~~ u~," u ^^. PA DEPARTMENT OF REVENUE 1 2 3 4 5 6 7 8 DEBTS AND DEDUCTIONS CLAIMED PART PAYEE DESCRIPTION DATE PAID AMOUNT PAID s TOTAL CEnter on Line 5 of Tax Computation) Under penalties of perjury, I declare that the facts I reported above ayre true~,Jcor~ ~t ~nd plete to the best of Y knowledge and belief. HOME C (/ 7) !~J ~// WORK C /T ) ~~3 ' S"~l~ ~~~~ ~~~/ / /~i~> ~ TELEPHONE NUMBER DATE PENNSYLVANIA INHERITANCE TAX -,r. ii-'FI~fORMATION NOTICE FILE N0. 21 11-0091 ~` "~_`"°' AND ACN 11146160 ~~, ~ a~~~`~'~'~'~AXPAYER RESPONSE DATE o7-14-2011 R ,.~ ~. j~3 . ~.t a' ~* ee: tt~ pLJs`~ Wr ~: d w,k ,,{ ~; *E 4 ~: 'ST 4do- } wr. ~9 wip• :'% /:~~j~'' ~~~j F M 0 a, ~ a o ti L >, ~e O o c~ ~ a~i C ~ J L ~ M ~ N O 3y~ 0 o aQ. ~s a, ~ a; h ~ N °° v° ~ ~ V ~d ` GJ C7~kl38W( l~f~OJ S,NtIHc1~0 ~~ ~~3~~ ~ihfti':: _. 1. .. ;.•p ._ ~~ t~ t+t ['~! ,-t i„ t (•.. a^f