HomeMy WebLinkAbout11-01-11~vMMONWEALTH OF PENNSYLVANIA
DEPAR7MEN7 OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 7 7 7 28-0601
RECEIVED FROM:
WILSON KENNETH L
51 SHERATON DR
CARLISLE, PA 17013
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PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ESTATE INFORMATION:
SSN: 191-18-2747
FILE NUMBER:
DECEDENT NAME:
DATE OF PAYMENT:
POSTMARK DATE:
COUNTY:
DATE OF DEATH:
REMARKS:
TOTAL AMOUNT F
CHECK# 874
INITIALS; HEA
SEAL
RECEIVED By;
2111-1168
WILSON CHARLES L
11/01/2011
11 /01 /201 1
CUMBERLAND
06/29/2011
REV-1162 EX(17-96)
NO. ~'p 015150
ACN
ASSESSMENT
CONTROL '~IMOUNT
NUMBER
GLENDA EARNER STRASgq GH
REGISTER OF W-LLS
REGISTER OF WILLS
BUREAU OF INDIVIDUAL TAXES
PO BOX 280601
HARRISBURG PA 17128-0601
PENNSYLVANIA INHERITANCE T
INFORMATION NOTICE
pennsy(va~~,~ ~ a ~ ~~ y.(/` AND
DEPgRTMENT OF REVENrH-Fr~ ~ '" ~I lytf ~1/ER RESPONSE
REV-]543 EX pFp (OS 1~y '.
- - ,'inn
FILE N0. 21- I' /%~
ACN 11168303
DATE 10-18-2011
~n,~~r w d~~j}: EST. OF CHARLES L WILS TYPE OF ACCOUNT
~ :s
$$jV ON ^ SAVINGS
191-18-2747
pt~~(.ERK n~ DATE OF DEATH 06-29-2011 ® CHECKING
ORPl~~;~~~~ ~ ~ COUNTY ^ TRUST
G'(11~t1(-~:;,~~,~, „ w CUMBERLAND ^ CERTIF.
KENNETH L WILSON ~'~' - I,~,~~~ REMIT PAYMENT AND FORMS T0:
51 SHERATON DR REGISTER OF WILLS
CARLISLE PA 17013-2124 1 COURTHOUSE SQUARE
CARLISLE PA 17013
M & T BANK
provided the department with the information below, which was used in calculating the inheritance tax due.
deceasedna~ndtanyaamount other thanhzerovisareflectedtbelow on the Potential Tax Du
t ou were a ,point owner/beneficiary of this account. If
notify the department of your relationship to the deceased by checking Box C in PART 1 below and wrltin
If you believe he information is incorrect, please obtain written correction from the financial institution, attach a co OU are the SpOUSe Of the
it to the above address. Please call 717-787-8327 with questions. a line, note no tax may be due, but you must
COMPLETE PART 1 BELOW * Dy'to0thie„form endTreturn
SEE REVERSE SIDE FOR FILING AND PevldruT r....~_..___
account No. 37401121 ~~ '
Account Balance
Percent Taxable
Amount Subject to Tax
Tax Rate
Potential Tax Due
PART
u
"ace 09-29-1997
Established
$ 3,702.80
X 50.000
$ 1,851.40
X .045
$ 83.31
To ensure proper credit to the account, two
copies of this notice must accompany
payment to the Register of Wills. Make check
payable to "Register of Nills, Agent".
N07E: If tax payments are lade within three
months of the decedent's date of death,
deduct a 5 percent discount On the tax due.
Any inheritance tax due will become delinquent
nine months after the date of death.
The above information
CHECK and tax due is correct.
Remit payment to the Register of Will
C
ONE s with
a discount or avoid interest, or return this
an official a two copies of
noti this notice to obtain
BLOCK
ssessment will be issued
~ the ce to the
PA Departm
t Register of Wills and
0 N L Y
B' ~ The
above asset has been en of Revenue.
or will be re orted and
filed by the estate representative, p tax
paid with
the Pennsylvani
i
C• ~ The
b a
nheritance tax return
a
ove informs ion is incorrre~ct and/or debts and deductions were
Complete PART 2~ and/or PART
below.
paid.
PART If indicating a different
relationship to decedent: tax rate, please state
TAX
LINE RETURN
- CALCULATION OF
1
D
TAX ON JOINT/TRUS ~~~ OP~,'
~~ DEPT
. ate Established
1 T ACCOUNTS
.PAD ~ `
2. Account Balance 2 $ ~ •:'
3.
4 Percent Taxable ~~~-
• Amount Subject to Tax y $ ~-
5. Debts and Deductions 5 - ~ '
6. Amount Taxable ~'
7• Tax Rate ~ X b ,,
_
$. Tax Due ~-"°~
PART
3^ E ' t''r'~
DEBTS AND DEDUCTIONS CLAIMED
DATE PAID PAYEE
DESCRIPTION
Under npnnlfr__ _
TOTAL CEnter on Line 5 of Tax c,.~,....._~,
:~~
;~r , ,..
AMOUNT PAID
--- re,~ury, I declare -------," $ --~
complete to the best of that the facts I reported above are true
my knowledge and belief.
correct and
cw ~/~ - HOME C ~ ~ ) SLg 6/O
AXPAYER SIGNATURE WORK ( )
TELEPHONE NUMBER -~LL=1~
DATE