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HomeMy WebLinkAbout10-04-11COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: ADAMS MAUREEN T 152 S 31ST STREET CAMP HILL, PA 1701 1 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ACN ASSESSMENT CONTROL NUMBER fold ESTATE INFORMATION: SSN: 168-36-3216 FILE NUMBER: 211 1-1044 DECEDENT NAME: ADAMS JOSEPH R DATE OF PAYMENT: 10/04/201 1 POSTMARK DATE: 10/03/201 1 COUNTY: CUMBERLAND DATE OF DEATH: 05/08/201 1 REV-1162 EX~11-96) NO. CD 015034 AMOUNT 11163847 ~ $2,480.60 11163848 ~ 575.20 TOTAL AMOUNT PAID: REMARKS: RECEIPT TO ATTY SEAL CHECK#1839 INITIALS: CJ RECEIVED BY: 52,555.80 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS <~.,~ PENNSYLVANIA INHERITANCE TAX ~~ INFORMATION NOTICE FILE N0. 21 BUREAU OF INDIVIDUAL T~~ '-, r^ --~ AND Po eox Zeo6ol ' !~ '{~fi111S~ ^ 18 ACN 11163848 HARRISBURG PA 17129-060H~ __ DEPAi}TMEN (l~gEgENUE TAXPAYER RESPONSE DATE 09-28-2011 ~~ ~ REV-1543 EX RFP (~~0JJ5 -1)) TYPE OF ACCOUNT "~ `'~''~ ~4 ~ ~ ~ • 1 ~ EST. OF JOSEPH R ADAMS © SAVINGS SSN 168-36-3216 ~ CHECKING ~~E~~ ~~ DATE OF DEATH 05-08-2011 ~ TRUST (~~t~'~~AI~ S !>(~l)~T COUNTY CUMBERLAND ~ CERTIF. CtlArt~F~~ a''' ~~~ PA REMIT PAY MENT AND FORMS T0: IVA L ADAMS REGISTER OF WILLS 104 CLARKTON CT 1 COURTHOUSE SQUARE LEMOYNE PA 17043-2011 CARLISLE PA 17013 SOVEREIGN BANK 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 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. 2334025828 Date 09-30-1998 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 $ 3,342.32 payable to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax payments are made within three Amount Subject to Tax $` 1 , 671 • 16 months of the decedent's date of death, )( . 045 deduct a 5 percent discount on the tax due. Tax Rate Any inheritance tax due will become delinquent Potential Tax Due $ 75 • 20 nine months after the date of death. TAXPAYER RESPONSE PART 0 FAILURE TO„ RESPUhIA W11LL 'RESULT T, ~A ~dFFIC>`°°Ai TAX ASSESS~'1ENT\ A. ~he above information and tax due is correct. u 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 CHECK an official assessment will be issued by the PA Department of Revenue. ONE C BLOCK 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 ~ and/or PART ~ below. PART If indicating a different tax rate, please state relationship to decedent: TAX RETURN - CALCULATION 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 lPAD ~O~~ICIA°L RISE ©N~Y ~ A~4F PA DEPARTMENT OF REVENUE 1 1 2 $ 2 , 4 $ 4 5 - 5 6 '~` 6 ~ X 7 8 $ 8 PART DEBTS AND DEDUCTIONS CLAIMED nwTr aern PAYEE DESCRIPTION AMOUNT PAID Under penalties of perjury, I declare that the facts I complete to the best of my knowledge and belief. TAXPAYER SI reported above are true, correct and HOME C 7/7 ) G'~'" ~ ~~ WORK C ) /b ~.~ // TELEPHONE NUMBER D TE 1 V 1/1L 1C111C1 v~, ~a.,c r ... ~.- FILE N0. 21 BUREAU OF INDIVIDUAL TAXES ACN 11163847 PO BOX 280601 HARRISBURG PA 17128-0601 DEPARTMENT OFF~B~'ENUE ~~';`~~ PAYER RESPONSE DATE 09-28-2011 REV-1543 El( AFP (05 11) TYPE OF ACCOUNT rr~~cc YYY ~' f ' i ~ ~~ ~ ~ ~ ~ 1', ~: _ , ~i i ~ r .. EST. OF JOSEPH R ADAMS ~ SAVINGS SSN 168-36-321b ~ CHECKING CLERK r DATE OF DEATH 05-08-2011 ~ TRUST QRP~;`~PY ~ ~ ~{j~T COUNTY CUMBERLAND ~ CERTIF. (~ "'~~~'~~~~~~-,yR`~' C'~'' ~A REMIT PAY MENT AND FORMS T0: IVA L ADAMS REGISTER OF WILLS 104 CLARKTON CT 1 COURTHOUSE SQUARE LEMOYNE PA 17043-2011 CARLISLE PA 17013 SOVEREIGN BANK 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 art 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 coDY 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. 2331046034 Date 09-01-1998 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 y` 110 , 249.01 payable to "Register of Wills, Agent". Percent Taxable X 50.000 NOTE: If tax payments are made within three Amount Subject to TaX $ 55, 124.51 months of the decedent's date of death, . 0 4 5 deduct a 5 percent discount on the tax due. Tax Rate X Any inheritance tax due will become delinquent Potential TaX DUe $ 2 ~ 480 • b0 nine months after the date of death. PART TAXPAYER RESPONSE FAILURE< T~7 RESP ~~II~,1~ R I~LTIhI ~ \ FC\ TAX ~ASSE~S \N~. A. (,~~rrle above information and tax due is correct. L~ 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 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 ~ and/or PART ~ below. PART If indicating a different tax rate, please state ~ ~ CI,FFII(I~L ~i.IS~ ONLY ~ ,~ l~AF relationship to decedent: PA DEPARTMENT OF REVENUE TAX RETURN - CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS D LINE 1. Date Established 1 1 ~` Z 2. Account Balance 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 ~ X 7 8 6 ~. 8. Tax Due ~ ~ ~ - Under penalties of perjury, I declare that the facts I reported above are true, correct and complete to the best of my knowledge an/dJ belief. HOME C /~L~L~L~17j~ ~~/`~`" WORK C ) ~ ~~/% TAXPAYER SIGNATURE TELEPHONE NUMBER D TE ~ PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE ~' AND pennsy ~n~~- ~ ~~_~~~ PART DEBTS AND DEDUCTIONS CLAIMED 0 ...rte .,. r., aevGF DESCRIPTION AMOUNT PAID USA J l! 9 ni h 1r1~ ...,s~, f'Z~ t { l:, l,j _ ' ^~ n ,~ ~ 1 1 k ~ ~•{_''r' d ~~~ -- ~~ ~a I .v ~ y } 77 i ~ ~: 4 s v i, y CEP! \ ~~ ,~ x~ a ~: ~: `~ rte! ~^ li..' y; ~+~~ +W 3i h i~ i !ter :~ e !r: ~ ~/ :.~ :;f IA`f Y~ m ~a :~mr ("d'~ ~ j v.r ~~ { Fi .u. £,j r r O N C7 V N ~ r U Q Q o o- ~ Y ~ L ~ T' ~ U ~ ~ ~ J sm 3~~ c ~~~ v T ~~ ~~~ ~t'i iYI {~~ j Sd;! .;.~ ~...~ .~.g 1 +~1