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Home My WebLink About08-08-11 (2)COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162EX111-96) NO. CD 014817 KLEIN DOROTHY E 5435 BONNYRIGG COURT MECHANICSBURG, PA 17050 fold ESTATE INFORMATION: SSN: Aso-26-5692 FILE NUMBER: 211 1-0859 DECEDENT NAME: CORKLE ELLEN L DATE OF PAYMENT: 08/08/201 1 POSTMARK DATE: 08/05/201 1 couNTY: CUMBERLAND DATE OF DEATH: 06/27/201 1 REMARKS: CHECK# 2861 ACN ASSESSMENT AMOUNT CONTROL NUMBER 11150023 ~ 512.48 TOTAL AMOUNT PAID: 512.48 INITIALS: CJ SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS ~~, PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE FILE N0. 21- II-~-'~5`j BUREAU OF INDIVIDUAL TAXES ~ Po Box zao6ol enn .C1%~T'llc'j -'-~~~ AND HARRISBURG PA 17128-0601 ~ ~ '~~ e~ ~7 ACN 11150023 DEPARTMENT ~0~1, AEV~NUE 'r f ^,41 AXPAYER RESPONSE DATE o7-27-2011 REV-1543 EX AFP(0$-11) -' `- ~-.'.! 'r3 ti~-"V ~'~'i ~~ ~u EST. OF ELLEN L CORKLE SSN 180-26-5692 ~«~~ ~~~ DATE OF DEATH 0 6 - 2 7 - 2 011 QRPN~,hI'~ ,,, T {tp~ v. JIJR~ COUNTY CUMBERLAND Ct1iViF` ~t 1~~r 4"'(~ PA, REMIT PAYMENT AND FORMS TD: DOROTHY E KLEIN REGISTER OF WILLS 5435 BONNYRIGG CT 1 COURTHOUSE SQUARE MECHANICSBURG PA 17050 CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. MEMBERS 1ST F CU 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 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 108460-40 Date 05-09-1989 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance $` 1 ~ 751.9( Payment to the Register of Wills. Make check payable to "Register of Wills, Agent". Percent Taxable X 16.667 NOTE: If tax payments are made within three Amount Subject to Tax $ 292.00 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 $ ._..~ ~ 13.14-~~ ~7~ nine months after the date of death. PART TAXPAYER RESPONSE FAILURE TO RESPOND WILL RESULT IN AN 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 C H E C K a discount or 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. BLOC 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 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 2 +fi 3 X 4 5 - 6 $ 7 X 8 $ PAD OFFICIAL USE ONLY ~ AAF PA DEPARTMENT OF REVENUE i 2 3 4 5 6 7 8 PART DEBTS AND DEDUCTIONS CLAIMED 3^ DATE PAID PAYEE DESCRIPTION AMOUNT PAID Unde enalties of perjury, I declare that the facts I reported above are true, correct and mplet to the best f nowledge and belief. H OME C ~ ) r WORK C ) ,~' //' TA PAYER SIG TURE TELEPHONE NUMBER AT IDIAL CEnter on Llne 5 of Tax Computation) $