HomeMy WebLinkAbout08-09-11 (2)COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
RE:V-1162 EX(11-96)
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
N0. CD 014821
BAER DONNA M
18 LONGWOOD DRIVE
MECHANICSBURG, PA 17050
fold
ESTATE INFORMATION: ssly: i so-zs-5ss2
FILE NUMBER: 21 1 1 -0859
DECEDENT NAME: CORKLE ELLEN L
DATE OF PAYMENT: 08/09/201 1
POSTMARK DATE: 08/05/201 1
COUNTY: CUMBERLAND
DATE OF DEATH: 06/27/201 1
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
1 1 150024 ~ $12.48
TOTAL AMOUNT PAID:
$12.48
REMARKS:
CHECK# 204
INITIALS: HMW
SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
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BUREAU OF INDIVIDUAL TAXES ~{.}
PD BDX 280601 penn~tv~lia
HARRISBURG PA 17128-0601 DE PARTMENT OF. R€uF,N UE
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PENNSYLVANIA INHERITANCE TAX ,~,~,,..
INFORMATION NOTICE FILE IVO. 21~ II ~~~.~
C, (jF AND ACN 11150024
-~ ~, TAXPAYER RESPONSE DATE 07-27-2011
CLERK C`=
~R~i`~~,iV ~ fL~~~RT
Cllti'Er~ ~' ~ ` ('il Ply.
DONNA M BAER
18 LONGWOOD DR
MECHANICSBURG PA 17050
EST. OF ELLEN L CORKLE
SSN 180-26-5692
DATE OF DEATH 06-27-2011
COUNTY CUMBERLAND
REMIT PAYMENT AND FORMS T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
TYF't ur Acl,uun i
SAVINGS
CHECKING
TRUST
CERTIF.
MEMBERS 1ST FCU 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 Sp0U5e 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 I 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 tc this form and return
it to the abova aAdrPSC Please call 77.7-787-8327 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
payment to the Register of Wills. Make check
Account Balance $ 1 ~ 751 • 96 payable to "Register of Wills, Agent".
Percent Taxable X 16.667
NOTE: If tax payments arcs made within three
Amount Subject to TaX $ 292 • 00 months of the decedent's date of death,
Tax Rate )( .045 deduct a 5 percent discount on the tax due.
Any inheritance tax due wall become delinquent
Potential Tax Due $` 13 • 14 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
a discount or avoid interest, or return this notice to the Register of Wills and
C H E C K an official assessment will be issued by the PA Department of Revenue.
C ONE
BLOC K B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania inheritance tax return
O N L Y filed by the estate representative.
C. ~ The above information is incorrect and/or debts and deductions were paid.
Complete PART ~ and/or PART ~ below.
PART If indicating a different tax rate, please state OFFICIAL USE ONLY U AAF
relationship to decedent: PA DEPARTMENT OF REVENUE
TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS PAD
LINE 1. Date Establistled 1 ~ r
2. Account Balance 2 $ 2
3. Percent Taxable 3 X 3
4. Amount Subject to Tax 4 $ 4
5. Debts and Deductions 5 5
6. Amount Taxable 6 `~ 6
7. Tax Rate 7 X 7
8. Tax Due 8 $ 8
PART DEBTS AND DEDUCTIDNS CLAIMED
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
Under penalties of perjury, I declare that the facts I reported above are true,s~correct and l /r~
compl to to the best of my knowledge and belief. HOME C ~~) / ~, -~~ ~„3~ _
WORK C 1 ~ ,~
TAXPAYER SIGNA UR TELEPHONE NUMBER AT
TOTAL (Enter on Line 5 of iax compuca a one a