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HomeMy WebLinkAbout11-16-11COMMONWEALTH OF PENNSYLVANIA REV-1182 EX~11-98- DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0801 PENNSYLVANIA RECE{VED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 015213 PALMER WILLIAM J III 3117 PHEASANT RUNE IJAMSVILLE, MD 21754 1uW ESTATE INFORMATION: SsN: ~s~-is-2101 FILE NUMBER: 2111-0923 DECEDENT NAME: PALMER WILLIAM J JR DATE OF PAYMENT: 11 / 16/2011 POSTMARK DATE: 11 /15/2011 COUNTY: CUMBERLAND DATE OF DEATH: 08/ 12/ 201 1 ACN ASSESSMENT AMOUNT CONTROL NUMBER 11163195 ~ 511.67 TOTAL AMOUNT PAID: $11.67 REMARKS: CHECK#1082 INITIALS: HMW SEAL RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE FILE N0. 21 11-0923 uREAU OF INDIVIDUAL TAXES AND ACN 11163195 ~o Box zaobol ~$~~~ ~~ ~` HARRISBUR6PA 17128-0601 pEP' jpEgEarenuE-- c TAXPAYER RESPONSE. '+~t i 7 DATE 09-26-2011 R ~L~A1Fx-.(1~-lY) lr~y~ til..~ TYPE OF AQCOUNT E~~ I P#Y ~ 6 PI'I i~: I v1 EST. OF WILLIAM J PALMER snvINGS SSN 191- 8-2101 ~ CHECKING CLERK ~F DATE OF D£ATH 08-12-2011 ^ TRUST 4~~^~r~5 CJURT COUNTY CUMBERLAND ^ CERTIF. CUM~E~LA~t~ `,~~,. PA REMiT PAYMENT AND FORMS T'0: WILLIAM.. J PALMER III REGISTER OF WILLS ,_ 3117 PHEASANY':RUN``.' L COURTHOUSE.:..SQUARE IJANSVILLE MD 21754-8919 CARLISLE PA' 17013 SOVEREIGN SANK provided the department with the information below, which was used in calculatinp,tha inheritaneG tax due. Records indicate that et the deith of the above named decedent, you were a ~otnt ownerlbeneftclary of this account. 2t you are tM pie @1 the deceased and any asount athet than `zero is reflected below on the Potential Tax Due line, note no tax say De dtra, ut'oa a~6st notify tAl~ d~pa~t~nt aY your relationship t0 the deceased by checkia9 Box~C in PART l below and Wrlttnq "spouse" in P RT Y If You believe he inrormation 1t incorrect, please obtain written correction iron the financial fnstitutton, attach a copy to;tMS fora a~{Sk~return it to the above address. ?lease cart 717-787-8327 with questions. COMPLETE PART i BELOW * SfE REVERSE SIDE FOR FILING AND PA~f.NENT INSTRUCTIGNS Account No. 1151155160 Dats 02-01-2010 To ansun proper cra(fitrto the account, trio Established eopirs of this notice cost biDCOmpai~gr, Account Balance 518.52 pawNnt to the Register of W111s. Makf ehatdc $ payabli+ tir "Rseistar of Wills, Aeent"." Percank Taxa~e X 50.000 _ NOTE: If tax, paorNnts.. era made within, throe Aalount Subject to Tax $ 259.26 months of the decedent's data of death, Tax Rat• )( .15 deduct a•5 percemtrdiscouat!sa the. tax dw. Any inheritance #ax dw will becesa dsliniuent Potential Tax Dw $ 38.89 nine mentfis'aftertM daft of deaths` P~T TiAX AVER E&PON$E , 1 > _ A. ~~"~'Ihs above fnfo"ttmatYort`ind tax d~~ is cornet. ,\ ,.,, ._ uu Remit o~ymant to, the R~9i;tm~ of Wills with two eopias.of this notSca to obtain >>:: CHECK a discount or avoid intarost, or roturn ,this notiFe to tM Register of Wills ahd ONE an official assessment will be issued br the PA Depsrtment of Revonw. [ BLOCK ~ B. ^ The above asset has been or will be roported and tax paid with tM Psnnsylvsnia iMwritance tax roturn ONLY filed by the •stat• ropresentative. C. y~ The above fnforaation is inevrr~ and/or debts and deductions were paid. ^-s Complete PART }l~J ahd/or P]ERf E~ below. PART It indiast3ne a different tmx rJoN, ploaao state relationsfiiv to decedent: S TAX RETURN -CALCULATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Dat• E~tat+lished 1 2. Account Balance 2 $ ` _ 3. Percent Taxabi• 3 X . . - - _ 4. Aeaount Sub~ect to Tax 4 ~ ~~~~~ 5. Debts and Deductions 5 -~ , 6. AMOUnt Taxable 6 $ 7. Tdx Rate 7 X 8.-Tax Due' 8 ~ PART ua:ai 1 s wnu uea~u~a auna e,s.wane:u DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under pwtfll"Itla~s,,of. pe~Jury, I declare tliAt th• facts i' reported abavv ar• truai, odrroc,t and a c U«# ;o i3iait; e.t, of my knowladDe and balitt• NONE C ~~ ~ ~i~,~~f~''r ~_ r r e~ ,~,~' r. yr` 'X',1//B~t„/~_ .. WORK C ) -I~r~/~~~ TAMP Y R IGNAT Rf T LEPHONE NUN ~~ItTE~- ,~ t ~ ,-~ ~ a ~~ j~ST.~L ,ASS ~ .., J ~ ~ ~~ t'+ ~. t ?y t '. ~ f: j , ~r'~ r ~. ~ ~' ~'~ 7 i ~ ~, E. r, .Y s ~*ti ~n:. ~ "~~ ~,t' ~~ r~ ~1r w ~ •. ~ ~ ~ ~l y ~,"~w ~. $~ ~~~ 3: ~ ~~~ ~~ ~~ ~ - ~ ~...:; ~* ~~~ ; ` ~~ _:_ Y G; ~ , ~ .. '-., _ ~ .. _, ~ t~ C: ~ M 7 ~~ ~ .~ O v~ ,, ~, ~- c., . C.'Y r ' LI ~ `4 ~ ~ h t':'+ j f. ' .i: , ~7 V ,,~ j ~ v ~ -7 \ { ~ - ~. J `/ _ ~ ~~ ~~ - ~~ ~^ ~'~ ~ l~`. '7