HomeMy WebLinkAbout11-21-11COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1 7 7 28-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1162 EXI11-961
NO. CD 015236
WOLF DOROTHY M
228 OLD YORK ROAD
DILLSBURG, PA 17019
-------- fold
ESTATE INFORMATION: SsN: 193-38-8630
FILE NUMBER; 21 1 1-1248
DECEDENT NAME: WOLF RONALD L
DATE OF PAYMENT: 1 1 / 21 / 201 1
POSTMARK DATE: 1 1 /21 /201 1
couNTY: CUMBERLAND
DATE OF DEATH: 10/30/201 1
REMARKS:
CHECK# 2028
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
11173735 ~ 56.98
TOTAL AMOUNT PAID: 56.98
INITIALS: CJ
SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF INDIVIDUAL TAXES
PO BOX 280601
HARRISBURG PA 17128-0601
-, PENNSYLVANIA INHERITANCE
INFORMATION NOTICE
?t111S~~MaR~d . ~- -~"'`F ~,~ AND
PARTMErrrc>cwk+,eNU~ ~ - ~~AXPAYER RESPONSE
,~
REV-1543 EX ~P (OS •11 )~ '. ~f
TAX
FILE N0. 21-~i ~~r~i `-~~j
ACN 11173735
DATE 11-09-2011
.r ~. i E i i :. , ~- EST. OF RONALD L WOLF
SSN 193-38-8630
^~ .-~,.~ inr
DATE OF DEATH 10-30-2011
;, ~ ~_,T COUNTY CUMBERLAND
C^^~ ~ - ,~• ~ a REMIT PAYMENT AND FORMS T0:
C~a" '' .~ L ~ J ~~ r r~ ~ REGISTER OF WILLS
DOROTHY M WOLF
COUNTRY MEADOWS 1 COURTHOUSE SQUARE
4905 E TRINDLE RD CARLISLE PA 17013
MECHANICSBURG PA 17050-3662
TYPE OF ACCOUNT
SAVINGS
CHECKING
TRUST
CERTIF.
MEMBERS 1ST F CU 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 Sp0U5e 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.
it touthelabove addresormaPleasescallo717~787p8327ewithaquestionsn correction from the financial institution, attach a copy to this form and return
COMPLETE PART 1 BELOW * S£E'"REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 161409-00 Date 11-15-1995 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 $ 310 19 payable to "Register of Wills, Agent".
Percent Taxable X 50.000
NOTE: If tax payments are made within three
Amount Subject to Tax $ 155.10 months of the decedent's date of death,
045 deduct a 5 percent discount on the tax due.
Tax Rate X . Any inheritance tax due will become delinquent
Potential TaX DUe $ 6 • 98 nine months after the date of death.
TAXPAYER RESPONSE
PART
FAILURE TO RESPOND WILL RESULT IN AN OFF ICIAL TAX ASSESSMENT
H E C K A. ~ The above information and tax due is correct.
Remit payment to the Register of Wills with
a discount or avoid interest, or return this
an official assessment will be issued by the
two copies of
notice to the
PA Department
this notice to obtain
Register of Wills and
of Revenue.
C 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
Complete PART ~ and/or PART ~ below. and deductions were paid.
PART
0
TAX
LINE
If indicating a different tax rate, Please state
relationship to decedent:
RETURN - CALCULATION
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 PAD
1 I
2 $ 2
s X 3
4 $ 4
5 - 5
6 $ 6
~ X 7
8 $ B
OFFICIAL USE ONLY ~fAAF
PA DEPARTMENT OF REVENUE
Under penalties of perjury, I declare that the facts I
complete ~o the best of my knowlgdge a~~ybelief.
TAXPA ER SIGNATUR
reported above are true, orrect and ~
WORK C ) / /~ ~/~ ~-.-'G'%/
TELEPHONE NUMBER ATE
PART DEBTS AND DEDUCTIONS CLAIMED
^3
,,.T~ ~ATTI pevFF DESCRIPTION AMOUNT PAID
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