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HomeMy WebLinkAbout09-29-11COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: SMART FREDA W 6010 WERTZVILLE ROAD ENOLA, PA 17025 fold PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ESTATE INFORMATION: ssrv: i85-3s-6205 FILE NUMBER: 2110-1231 DECEDENT NAME: SMART BENJAMIN H III DATE OF PAYMENT: 09/29/201 1 POSTMARK DATE: 09/29/201 1 COUNTY: CUMBERLAND DATE OF DEATH: 1 2/ 1 1 /2010 ACN ASSESSMENT CONTROL NUMBER AMOUNT 11117574 ~ 5777.85 TOTAL AMOUNT PAID: REMARKS: CHECK# 1085 SEAL INITIALS: CJ RECEIVED BY: 5777.85 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REV-1162 EX111-961 NO. CD 015017 REGISTER OF WILLS INFORMATION NOTICE BUREAU OF INDIVIDUAL TAXES r A N D PD Box 2BB6o1 ' ~r`f.~F ~rTAXPAYER RESPONSE HARRISBURG PA 17128-0601 ~ ; ~~~ ~ C ~' REV 154E E% RFP (OB- ~1 FILE N0. 21 10-1231 ACN 11117574 DATE 03-16-2011 ', ~ ^ 1') r. r... .~tLl L ~-1 rj i J t G',' ~~~~i~ Q~P~~ + _~ "", S ,~)l~R~ FREDA W SMART 6010 WERTZVILLE RD ENOLA PA 17025-1159 EST. OF BENJAMIN H SMART SSN 185-38-6205 DATE OF DEATH 12-11-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT © SAVINGS CHECKING TRUST CERTIF. BELCO COMMUNITY CREDIT UNION provided the Department with the information below, which has been used in calculating the potential tax due. Records indicate that at the death of the above-named decedent, you were a ioint owner/beneficiary of this account. If you feel 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. This account is taxable in accordance with the Inheritance Tax laws of the Commonwealth of Pennsylvania. Please call (717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 046870 Date 09-15-1972 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance $ 23, 933.45 payment to the Register of Wills. Make check payable to "Register of Wills, Agent". Percent Taxable X 16.667 Amount Subject to Tax ~` 3, 988.99 NOTE: If tax payments are made within three months of the decedent's date of death, Tax Rate )( .045 deduct a 5 percent discount on the tax due. Potential Tax DUe Any Inheritance Tax due will become delinquent $ 179.50 nine months after the date of death. PART TAXPAYER RESPONSE 1^ 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 check box "A" and return this notice to the Register of 0 N E Wills and an official assessment will be issued by the PA Department of Revenue. B L 0 C K ~ g, ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return 0 N L Y to be 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 3L-J below. PART >.r intlicating a tlifferent tax rate, please state relationship to decedent: TAX RETURN - COMPUTATION LINE I. Date c'~tBblished 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 i 2 $ 3 X 4 5 6 7 X s $ PAD OFFICIAL USE ONLY ~ AAF PA DEPARTMENT OF REVENUE 1 2 3 4 5 6 7 8 PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMniiNT porn Under penalties of perjury, I declare that the facts I have reported above are true, correct and c m lete to the best of my knowledgenand belief. HOME C ~~~ ) ~ci ~ ~ ~~ ~Ottir~ c3 ~'l: ~"~c)Y4 ).--4 WORK C 7 ! ~ ) ~S(~ / 7G z- /'c~ ) `% ~7 ii TAXP YER SIGNATURE TELEPHONE NUMBER DATE un amine ~ or )ax computation) $ BUREAU OF INDIVIDUAL TAXES PO BOX 280601 HARRISBURG PA 17128-0601 REV~I~i43--EX..AFP.(OB-p8~~ PENNSYLVANIA INHERITANCE T INFORMATION NOTICE AND ,`,,`~- (~~: TAXPAYER RESPONSE ,c j n.~ LEr~~~. r~F OPF~r~k,~, ~ ~;!~; Cl lh++ ~~ ~, - . ~~ n r F1 DARRELL L MCMILLIAN 103 N MADDER DR MECHANICSBURG PA 17050-5211 FILE N0. 21 10-1231 ACN 11117575 DATE 03-16-2011 EST. OF BENJAMIN H SMART SSN 185-38-6205 DATE OF DEATH 12-11-2010 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TYPE OF ACCOUNT SAVINGS CHECKING TRUST CERTIF. BELCO COMMUNITY CREDIT UNION provided the Department with the information below, which has been used in calculating the potential tax due. Records indicate that at the death of the above-named decedent, you were a joint owner/beneficiary of this account. If you feel 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. This account is taxable in accordance with the Inheritance Tax laws of the Commonwealth of Pennsylvania. Please call (717) 787-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 046870 Date 09-15-1972 To ensure proper credit to the account, two Established copies of this notice must accompany Account Balance $ 23, 933.45 Payment to the Register of Wills. Make check Percent Taxable X Payable to "Register of Wills, Agent". 16.667 Amount Subject to Tax $ 3, 988.99 NOTE: If tax payments are made within three Tax Rate months of the decedent's date of death, X . 1 5 deduct a 5 percent discount on the tax due. Potential TeX DUe $ 598.35 Any Inheritance Tax due will become delinquent nine months after the date of death. PART TAXPAYER RESPONSE FAILURE TO RESPDND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT A. f~f The LJ above information and tax due is correct. Remit payment to the Register of Wills with two copies of di this notice to obt i CHECK a scount or avoid interest, or check box "A" and return a n this noti t C 0 N E Wills and an official assessment will be issued by the PA ce o the Register of Departm t f ~ BLOC K en o Revenue. 0 N L Y B. ~ The above asset has been or will be re orted and tax p paid with t b the Penns lv i o e filed by the estate representative. y an a Inheritance Tax return C. ~ The above informs ion is incorrect and/or debts and deduction s Complete PART ~2 and/or PART 3LJ below. were paid. rqm .~ inuica a ng a altferent tax rate, please state relationship to decedent: TAX RETURN - COMPUTATION 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 $ 3 X 4 5 6 7 X 8 PART ^3 DATE PAID PAYEE DESCRIPTION AMOUNT PAID TOTAL CEnter on Line 5 of Tax Computation) g Under penalties of perjury, I declare that the facts I have reported above are true, correct and complete to the best of my knowledge and belief. ,~,/ ~ HOME ( ~~~ ) ~y7~ ^ 0!'7 Z ~r~ ' ~ _ ` G~j'iI `--~_ WO R K C ~l ~T ) 7 ~ .' D L~ GI ^ Z `7."(( TAXPAYER SIGN TURE TELEPHONE NUMBER DATE PAD 1 2 3 4 5 6 7 8 DEBTS AND DEDUCTIONS CLAIMED OFFICIAL USE DNLY ~ AAF PA DEPARTMENT DF REVENUE ;~ >t 4=~ :rte. ~,;<'s. ~. ~~ a;; 'd {: ~:~- a.~ s,i . e.~t g7s i'r a °n I ~~ m M V ~ ~ ?~ O ~ J ~ U ~ ~ d ~ ~ oG -- X11 ~i~=i IJ Vii, ~`~: a - ~: 1~ ,, . _ ~~ tS~ ;ii i ~;t ~.~_; i °t .`,..f