Loading...
HomeMy WebLinkAbout10-04-11REV-1162EX(11-96) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: MCINTIRE BOPHA T 1 139 COUNTRY CLUB ROAD CAMP HILL, PA 17011 Sold ESTATE INFORMATION: FILE NUMBER: DECEDENT NAME: DATE OF PAYMENT: POSTMARK DATE: COUNTY: DATE OF DEATH PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT SSN: 213-38-0563 2111-0165 MCINTIRE BURTON W 10/04/2011 10/04/201 1 CUMBERLAND 01/02/2011 TOTAL AMOUNT PAID: REMARKS: CHECK# 412 SEAL INITIALS: CJ RECEIVED BY: NO. CD 015031 526.38 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS ACN AMOUNT ASSESSMENT CONTROL NUMBER BUREAU OF INDIVIDUAL TAXES Pe~1~a PO BOX 280601 HARRISBURG PA 17128-0601 DEPARTMENT OF REVENtlE yF ~ ^. REV-15635~)j, ACP <d5`ll)`~ PENNSYLVANIA INHERITANCE T INFORMATION NOTICE AND ~;_~:~ o~ - , ';` ~.~ TAXPAYER RESPONSE C~~~~~ o~~r~~~s ~o~ ~~3 Ct1M~;~k~' ~.~~ r ;~ PA MCINTIRE K MALOU 318 BEVERLY RD PA 17011-2813 CAMP HILL FILE N0. 21 11-0165 ACN 11162541 DATE 09-21-2011 EST. OF BURTON W MCINTIRE SSN 213-38-0563 DATE OF DEATH of-02-2011 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT © SAVINGS CHECKING TRUST CERTIF. provided the department with the information below. which was used in calculating the inhbUt ayOU mu5tue. Records indicate that at nee death of the above named decedent, you wore a joint owner/beneficiary of this account. If yoD are the spouse o e PsECU ouse" in PART 2. other than zero is reflected below on checkingnBoxlCTin PART1lnbelowtandowritingY"SP due, deceased and any amou notify the department of your relationship to the deceased Y If ycu bel,,eve the information is ~r.correct, please obtain written correction from the financial institution, attach a copy to this form an re urn it to the above address. Please call 717-787-8327 with questions. r.wor ~ nG10W * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS^'^t two conrLt ~ c ~.,~ . - --- 05-12-1999 .,,~ ....--- 7o ensure proper c n Account No. 0213380563 Date y copies of this notice must accompa Register of Wills. Make check th Established 3 ~ 517 , 67 e payment to payable to "Register of Wills, Agent". Account Balance $ X 16.667 NOTE: If tau payments are made within three th d Percent Taxable 5 8 6 .2 9 , ea months of the decedent's date of t on the tax due. Amount Subject to Tax $ , 045 deduct a 5 percent discoun inheritance tax due will become delinquent A Tax Rate X 26.38 nv nine months after the date of death. Potential Tax Due ~` PART CHECK ONE C BLOCK ONLY TAXPAYER RESPONSE AILURE~TO RESPOND WILL R LT IN AN OFFICIAL TAX ASSESSMENT A, ~/ The above information and tax due is correct. Ipl 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 an official assessment will be issued by the PA Department of Revenue. g, ~ The above asset has been or will be reported and tax paid with the Pennsylvania inheritance tax return filed by the estate representative. C, ~ The above informs ion is incorre~t belowr debts and deductions were paid. Complete PART 2~ and/or PART ,ter nui V n AAF If indicating a different tax rate, Please state urr tt.ir.~ a,,...~ ~. - PA DEPARTMENT OF REVENUE PART relationship to decedent: s OF TAX ON JOINT/TRUST ACCOUNTS PAD TAX RE TURN - CALCULATION 1 LINE 1. 1 Date Established 2 2. 2 Account Balance X 3 3. Percent Taxable 3 $ 4 4. Amount Subject to Tax 4 5 5. Debts and Deductions 5 $ 6 6. Amount Taxable 6 X 7 7. 7 Tax Rate 6 r..., rn~a $ ~., ~~ DEBTS AND DEDUCTIONS I,LAlr,cu PART DESCRIPTION DATE PAID PAYEE s on Line 5 of Tax Computation) AMOUNT PAID TOTAL (Enter /~ Under penalties of perjury, I declare that the facts I repor HOME ov(~]'~'t ~ e7correc~ (J ~ // complete to the best of my knowledge and belief. WORK ('l ~ /~ - ~-F !~ D A TELEPHONE NUMBER .vnwVCD crrNATURE