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Home My WebLink About08-30-11COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280801 HARRISBURG, PA 1 7 1 2 8-0601 RECEIVED FROM: COHEN ELISA S 3122 YALE AVENUE CAMP HILL, PA 17011 +oa PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EXI11-96) NO. CD 014906 ACN ASSESSMENT AMOUNT CONTROL NUMBER ESTATE INFORMATION: SSN: 200-50-5024 FILE NUMBER: 211 1-0919 DECEDENT NAME: LYTLE TAMI N DATE OF PAYMENT: 08/30/201 1 POSTMARK DATE: 08/29/201 1 COUNTY: CUMBERLAND DATE OF DEATH: 05/31 /201 1 REMARKS: ELISA S COHEN CHECK# 568 SEAL 11150654 ~ 5142.24 TOTAL AMOUNT PAID: INITIALS: WZ RECEIVED BY 5142.24 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INOIYIUWL TAXES Po Box zaosgl HARRISBURG PA 17128-0601 ~ -. (}~ AND ol"'ErA'.. leatu~'~~'r~~~"'~''TAXPAYER RESPONSE i(t ~ C EEV•35f3 Sit fie •~1k>.. -~i ~' '~'w~,•'•, TAX ~~ FILE NO. 21--1'~~ ACN 11150654 DATE 07-29-2011 PENNSYLVANIA INHERITANCE INFORMATION NOTICE 4 ~l1C 30 ~'~., qC: C1 i, CLERK 0~ CR~~~S~ ~ ~R~PA ELISA S COHEN ~)M~ER~.,~.C~ ~~`~ 3122 YALE AVE CAMP HILL PA 17011 EST. OF TAMI N LYTLE SSN 200-50-5024 DATE OF DEATH 05-31-2011 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS ® CHECKING TRUST CERTIF. PSECU 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 dai nt owner/beneficiary of this account. If you ere the SpgUSe Of the decessed 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 Lo the deceased by checking Box C in PART 1 below and Writing "spouse" in PART 2. If you Detieve the information fs incorrect.~Dl ase obtain written correction from the flnanciat institution, attach a copy to this form and return it to the above address. Please ca 11 717-787-B~T w-ftti Questions. COMPLETE PART 1 BELOW ^ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 9301229119 Data 10-29-2002 To ensure proper credit to the account, two Establishatl copies of this notice must accomparo Account Balance 1,996.35 payment to the Register of Wills. Make check payable to "Register of Wills. Agent^. Percent Taxable X 50.000 NOTE: It tax payments are made within three Amount Subject to Tax $ 998.18 months of the decedent's date of death, Taz Rmt• X , 1 rj deduct a 5 percent discount on the tax due. Aro inheritance tax duo will become delinquent Potential Tax Due $ 149.73 1C ~j fe:)N2.1'f nine months after the date of death. PART TAXPAYER RESPONSE A. ~ Tha above information and Lax due is correct. Remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or return this notice to the Rmpister of Wills and CHECK an official assessment will be issued by the PA D.partmant of Ravenna. C ONE ~ BLOCK B, ~ 7h• above asset has been or will be reported and tax paid with the Pennsylvania inheritance tax return ON L Y filed by the estate raprasentetive. C. ~ Tha above info a ion is ineorr et and/or debts and deductions ware paid. Complete PART ~ and/or PART ~ below. PART If indicating a difforent tax rata, plaasm state relationship to decedent: TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS iiNE i. Da#e EstTftriYsha9 2. Account Balance 3. Percent Taxable 4. Amount Subject to Taz 5. Debts and Deductions 6. Amount Taxable 7. Taz Rat• 8. Tax Due 1 2 ¢ 3 X 4 5 6 ~ T X 8 $ PART DEBTS AND DEDUCTIONS CLAIMED ^3 DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I reported above are true, correct and complete to the best of my knowledge and belief. HOME C ) WORK C ) TAXPAYER SIGNATURE TELEPHONE NUMBER DATE ~~'4~~^~.'.JL,.V.~ W~~ ~ ~~ tL IVI~P r" r ~ ~. Yx, ~,. -,p< ~~' II.. PZ:; ~! l.a., t 0 ( }~y ~~ Lj;: y~ ir:} ~: ~, tx~ '~'} nk: CLERK OF QRPHAN'S COURT CIJMFFR!_,4~~i1 CO . PA ~ _ ~ ~ y ~ ~ ~ r V w V`(T, ^ V• ` L ~ C V .~ .~ ,^ .= .~ .~: .', :.;. ..,: z .~. i'Y •M l~ ~' .~ l?y ^~ c~ J ~ ~ 7~ ~ ~ M v M