Loading...
HomeMy WebLinkAbout09-14-11COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 014964 HARE ANITA 128 N FILEYS ROAD DILLSBURG, PA 17019-9506 fold ESTATE INFORMATION: SsN: 229-36-9286 FILE NUMBER: 211 1-0973 DECEDENT NAME: WEBB SYLVIA W DATE OF PAYMENT: 09/ 14/201 1 POSTMARK DATE: 09/03/201 1 COUNTY: CUMBERLAND DATE OF DEATH: 06/23/201 1 REMARKS: CHECK# 744 SEAL ACN ASSESSMENT AMOUNT CONTROL NUMBER 11149556 ~ 551.92 TOTAL AMOUNT PAID: INITIALS: CAJ REV-1162 EX111-96) 551 .92 RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS ~~ PENNSYLVANIA INHERITANCE TAX ~~' INFORMATION NOTICE FILE N0. 21-11--x} (_ BUREAU OF INDIVIDUAL TAXES r- PD Box zaocol penglu~nia ,~.. tit- AND ACN 11149556 HARRISBURG PA 17128-0601 DEPARTMEC{T-0FREVENIiE ,, ~ O TAXPAYER RESPONSE REV-1543 YX 41~P`,~(OS-11) ` i j DATE 0 7 - 25 - 2011 ` ~ EST. OF SYLVIA W WEBB SSN 229-36-9286 ~~ ARE<, ~~Ji DATE OF DEATH o6-23-2011 e 4 ~n~,t ^T Qt~~~``J .: ~ ~ )rS. COUNTY CUMBERLAND ~ll~!J:~~~' ~" ` i . " ~a, REMIT PAYMENT AND FORMS T0: ANITA W HARE REGISTER OF WILLS 128 N FILEYS RD 1 COURTHOUSE SQUARE DILLSBURG PA 17019-9506 CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS © CHECKING TRUST CERTIF. PNC BANK NA 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 y0U 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. 5003498097 Date 07-02-2001 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance $ 7 ~ 287 00 payment to the Register of Wills. Make check " . payable to Register of Wills, Agent". Percent Taxable X 16.667 Amount Subject to Tax $ 1 214 52 NOTE: If tax payments are made within three ~ . months of 's,~,ate of death, Tax Rate )( .045 deduct 5 percent discoun on the tax due. Potential Tax DUe $ 54.65 Any inheritance x ue will become delinquent nine months after the date of death. PART TAXPAYER RESPONSE FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT A. ~he above information and tax due is correct. x-14 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 an official assessment will be issued by the PA Department of Revenue. ONE 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 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 ~ below. PART If indicating a different tax rate, please state relationship to decedent: TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS 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 1 2 $ 3 X 4 $ 5 6 $ 7 X 8 $ PART 3^ PAD OFFICIAL USE ONLY ~ AAF PA DEPARTMENT OF REVENUE 1 2 3 4 5 6 7 8 DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) 8 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 ( ~ TAXPAYER SIGNATURE TELEPHONE NUMBER DATE vsn ^ x o ,~ s ,~ ~ ~ ~~ g. "A.. ~>'. l ~w Y fl i 0 ~ ~o ~~ Q O ~o d~~ Y y' A ~ ~ ~ ~z~ ~~o -.3~~ ~, '^4 i _, ~` j .{~ 1 ` `( JV' ~ .... _...J ~r; ••, ld3 l~ .;.; F'•. •i•{