Loading...
HomeMy WebLinkAbout11-29-11 (2)I _ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT MONROE STEPHEN R 331 A STREET CARLISLE, PA 17013 told ESTATE INFORMATION: ssrv: is3-58-4iss FILE NUMBER: 211 1-1275 DECEDENT NAME: MONROE DAWN M DATE OF PAYMENT: 1 1 /29/201 1 POSTMARK DATE: 1 1 /28/201 1 COUNTY: CUMBERLAND DATE OF DEATH: 08/ 1 9/201 1 REMARKS: SEAL CHECK#1137 REV-1162EX111-96) NO. CD 015265 ACN ASSESSMENT AMOUNT CONTROL NUMBER 11 159141 ~ 54.19 TOTAL AMOUNT PAID: 54.19 INITIALS: DMB RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS ~ PENNSYLVANIA INHERITANCE TAX _ INFORMATION NOTICE FILE N0. 21 1!' ~ ~~~-~ BUREAU OF INDIYIDUAL TAXES r, ,. :r, •, . PO BOX 280601 ~ S/t [ ~ ANO ACN 11159141 HARRISBURG PA 17128-0681 ~hs ~.VB!C118; .[• ~' oE~geTMErYroFaevewue ;, `, TAXPAYER RESPONSE DATE 08-31-2011 REY-1543 EX AFP (OS-11)' ~-~.~ TYPE OF ACCOUNT •! ! ~ ~ L lj 1^ J~ I ~ 1 ~ e ~- OF EST DAWN M MONROE ® SAVINGS . SSN 193-58-4189 ~ CHECKING C ~~' DATE OF DEATH 08-19-2011 ~ TRUST C~r~ ~ ~?T COUNTY CUMBERLAND ~ CERTIF. 1 C~~~~i~''~ `( `ir 1 ~M REMIT PAYMENT AND FORMS T0: TAYLOR N MONROE REGISTER OF WILLS 331 A STREET 1 COURTHOUSE SQUARE CARLISLE PA 17013 CARLISLE PA 17013 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 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. 17231b-00 Date 11-24-1997 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 $ 559.31 payable to "Register of Wills, Agent". Percent Taxable X 16.667 NOTE: If tax payments are made within three Amount Subject to TaX $ 93.22 months of the decedent's date of death, Tax Rate )( .045 deduct a 5 percent discount on the tax due. Any inheritance tax due will become delinquent Potential Tax Due $ 4 • 19 nine months after the date of death. PART TAXPAYER RESPONSE FA UitE T R O W R~SU T_ ,uOF CI T, S S E T The A. above information and tax due is correct. ~ 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. C ONE B L ~ 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 revresentative. C. ~ The above informs ion is incorrect and/or debts and deductions were paid. Complete PART 2~ and/or PART a below. PART 0 TAX If indicating a different tax rate, please state relationship to decedent: 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 1 2 $ 3 X 4 `~ 5 - 6 $ 7 X 8 $ OFFICIAL"~ #J~E"~Ot~LY ~,q~AF~ PA DEPARTMENT OF REbENUE ~D l ~~ 2 , 3 4 5 ~~.. 6 - 7 ~' a ~ ~. ~ PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID R SIGNATURE TELEPHONE NUMBER DATE Under penalties of perjury, I declare that the facts I reported above are true, coo/rr?ect taJnd ¢ comple t e be of my nowledge and belief. HOME C ~f7 ) ~7J"' ©~L~U WORK (ZI ? ) q3~' !s'~q~ .~,, ~'" ~'~ ~; ~r'>> ~~ 4 "~ ~d s ~~ ~?_ ~~~: ~Y F ~~ l~F 4~) J~~ ~~ } ~r4 ~..~ •a~! M_ c~ :, y .~ ~ . -.. .,, ~ ~~. ': 4 •f r~ :01 ~•k ~_~_,7, ~, ` _ ~ ~. ~ ~. N c~